MESSAGE FROM THE DIRECTOR
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MILITARY TRAINING NETWORK ADMINISTRATIVE HANDBOOK
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ACLS [pic] PALS
ATLS
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Military Training Network Mission and Vision
Mission
The Military Training Network (MTN) has been recognized as an American Heart Association Regional Training Center since 1984 and as the American College of Surgeons Region 13 Program Coordinator since 1996. The mission of the MTN is to develop and implement policy guidance and ensure compliance with curriculum and administrative standards for resuscitative and trauma medicine training programs for uniformed service members and Department of Defense affiliates worldwide. The tri-service staff provides specific service expertise, worldwide coordination of programs, central record keeping, ensures national resuscitative and trauma medicine organizations are aware of military medicine's unique requirements.
Vision
MTN seeks to increase Department of Defense (DoD) Medical Readiness in both garrison and combat while reducing administrative costs
MESSAGE FROM THE DIRECTOR
The MTN which is funded by the DoD, provides seamless resuscitative medicine and trauma programs to all eligible personnel including uniformed service members and DoD employees.
The MTN Administrative Handbook provides guidance for resuscitative medicine and trauma training programs. This edition (6th Edition – January 2014) supersedes all previous editions. The MTN Administrative Handbook implements the program and course specific guidelines found in:
1. The American Heart Association (AHA) Instructor Manual for Basic Life Support (BLS), 2011.
2. The American Heart Association Instructor Manual for Heartsaver First Aid CPR AED (HS CPR AED), 2011.
3. The American Heart Association Instructor Manual for Advanced Cardiac Life Support (ACLS), 2011.
4. The American Heart Association Instructor Manual for Pediatric Advanced Life Support (PALS), 2012.
5. The American Heart Association Instructor Manual for Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS), 2012.
6. The American College of Surgeons' Advanced Trauma Life Support (ATLS®) for Doctors, Faculty Manual, 9th Edition, 2012.
7. The American Heart Association Program Administration (PA) Manual, 5th Edition, February 1, 2013 (U.S. Version).
The handbook is prepared by the MTN and made available on line to all affiliated training sites to assist in the smooth, effective management of BLS, ACLS, PALS, PEARS, and the coordination of ATLS.
This handbook can be found at our website: . Periodic updates and information on MTN programs can be located at this website.
PAULETTE KING, Lt Col, USAF, NC
Director, Military Training Network
Uniformed Services University
CONTACTING THE MILITARY TRAINING NETWORK
Military Training Network
USUHS Southern Region
2787 Scott Road
JBSA Fort Sam Houston Texas, 78234-7679
Phone: 210-808-4484 DSN 420-4484
E-mail: mtnreports@usuhs.edu
Website:
|MTN Director |Comm 210-808-4484 |DSN 420-4484 |
| |Comm 301-295-0964 |DSN 295-0964 |
|MTN NCOIC |Comm 210-808-4482 |DSN 420-4482 |
|ACLS Program Manager |Comm 210-808-4481 |DSN 420-4481 |
|Air Force BLS Program Manager |Comm 210-808-4477 |DSN 420-4477 |
|Army BLS Program Manager |Comm 210-808-4475 |DSN 420-4475 |
|Navy BLS Program Manager |Comm 210-808-4480 |DSN 420-4480 |
|PALS/PEARS Program Manager |Comm 210-808-4482 |DSN 420-4482 |
|ATLS Program Coordinator |Comm 210-808-4482 |DSN 420-4482 |
|Information Manager/Webmaster |Comm 210-808-4478 |DSN 420-4478 |
|Program Assistant |Comm 210-808-4484 |DSN 420-4484 |
If you cannot reach your Program Manager, call the main phone number at
Comm 210-808-4484 DSN 420-4484.
|TABLE OF CONTENTS |
| |
|Chapter 1 – The Military Training Network |Page 6 |
|MTN Mission |Page 7 |
|MTN Purpose |Page 7 |
|MTN Goals |Page 7 |
|Purpose of The Administrative Handbook |Page 7 |
|Structure of the Military Training Network (MTN Staff) |Page 8.9 |
|Training Sites |Page 10 |
|Satellites |Page 10,11 |
|1-8 Who May Participate in MTN Programs |Page 11 |
|Chapter 2 – Administration of Resuscitative Medicine Courses |Page 12 |
|Introduction |Page 13 |
|Administration of MTN Programs |Page 13 |
|Training Site Responsibilities |Page 13-15 |
|Training Site Documents |Page 15 |
|Training Site Review |Page 15,16 |
|Affiliating with the MTN |Page 16,17 |
|Re-Affiliation |Page 17 |
|Dis-Affiliation |Page 17,18 |
|Placing a Program on Temporary Hold |Page 18 |
|Dispute Resolution |Page 18-19 |
|Request for Additional Cards |Page 19 |
|Reciprocity |Page 20 |
|Instructor Records |Page 20,21 |
|Maintenance of Course Records |Page 21,22 |
|Continuing Education (CE) |Page 22 |
|Electronic Communications |Page 22 |
|Revoking Instructor Status |Page 23 |
|ECC Courses Available through the MTN |Page 23 |
|CBT Learning Systems |Page 24-26 |
|MTN Course Criteria |Page 26,27 |
|Skills Testing |Page 27 |
|Written Examinations |Page 27,28 |
|Remediation |Page 28 |
|Instructor to Student Ratio |Page 28,29 |
|Renewal |Page 29,30 |
|Challenge Option |Page 31 |
|Deployed Personnel |Page 32 |
|AHA Instructor Essentials Courses (discipline-specific) |Page 33 |
|Infection Control |Page 33,34 |
|Equipment Familiarization Training |Page 34 |
|Chapter 3 – Position Descriptions, Duties and Responsibilities |Page 35 |
|Training Site Responsibilities |Page 36 |
|Training Site Staff |Page 36-41 |
|Administrative Separation of Duties |Page 42 |
|Course Director Orientation |Page 42 |
|Chapter 4 – Course Materials and Equipment |Page 43 |
|Course Materials |Page 44 |
|Non-AHA Material/Information |Page 44 |
|Copyright of AHA Materials |Page 45 |
|Training Equipment |Page 45 |
|Quality Assurance |Page 45 |
|Controlled Items |Page 45 |
|4-7 Instructor Materials |Page 46 |
|Chapter 5 – Reports |Page 47 |
|5-1 Reports |Page 48 |
|5-2 Basic Life Support Reports |Page 48,49 |
|5-3 ACLS, PALS Reports |Page 49,50 |
|5-4 Annual or Semi-Annual Report Delinquency |Page 50 |
|5-5 Re-Affiliation |Page 51 |
|Chapter 6 – Resuscitative Medicine Courses |Page 52 |
|MTN Provider Courses |Page 53,54 |
|6-2 MTN Instructor Courses |Page 54-57 |
|Chapter 7 – Training Site Reviews |Page 58 |
|Introduction |Page 59 |
|Training Site Responsibilities |Page 59 |
|Scheduling Training Site Reviews |Page 60 |
|Self-Assessment Reviews |Page 60 |
|Administrative Review |Page 60,61 |
|Course Monitoring Review |Page 61 |
|7-7 Scoring and Remediation |Page 61,62 |
|Chapter 8 – Advanced Trauma Life Support |Page 63 |
|Introduction |Page 64 |
|Administration of MTN ATLS Programs |Page 64 |
|MTN ATLS Program Manager |Page 65 |
|Training Site Responsibilities |Page 65 |
|ACS Course Material |Page 65,66 |
|Written Examinations |Page 66 |
|Training Equipment |Page 66 |
|Training Site Staff |Page 66-68 |
|Instructor Records |Page 68 |
|Student Instructor Post Course Reports |Page 68 |
|Maintenance of Course Records |Page 68 |
|ATLS Course Procedures |Page 68,69 |
|ATLS Support Courses |Page 69-73 |
|Instructor Revivification |Page 73 |
|Requesting New Training Site |Page 73 |
|APPENDIX |
|Appendix A: Forms |
|Appendix B: Example Forms |
|Appendix C: AHA/MTN Course Completion Cards |
|Appendix D: Training Site Reviews (Administrative Review/Course Monitoring Review) |
Chapter 1: The Military Training Network (MTN)
1-1. MTN Mission
The DoD Health Council established the MTN in 1982. The MTN is organized under the Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Maryland. The MTN has been recognized as an American Heart Association (AHA) Regional Training Center since 1984 and as the American College of Surgeons (ACS) Region 13 Program Coordinator since 1996. The mission of the MTN is twofold:
• Develop and implement policies for resuscitative and trauma medicine training programs.
• Provide curricular and administrative oversight to a worldwide network of affiliated training sites.
The MTN oversees the implementation of the AHA and the ACS training programs to support the needs of the DoD, US Coast Guard, and other US government organizations.
1-2. MTN Purpose
Training sites are authorized to conduct their own self-sustaining resuscitative and trauma medicine training courses in accordance with MTN and AHA guidelines. MTN affiliated training sites offer cost-effective training compared to premium costs charged by civilian training programs. Training sites have expert faculty, administrative support, equipment and supplies. Local control of resources affords the training sites optimum flexibility to sustain a qualified, competent, and ready workforce. The MTN’s centralized record keeping permits our highly mobile workforce to maintain transferable qualifications. This eliminates the need for re-training due to deployment or change of station and allows units to conduct training in the field.
1-3. MTN Goals
Maintain the integrity and standards of the AHA, ACS and the DoD.
Ensure training sites comply with AHA Guidelines through site visits, course monitoring and record audits.
Provide responsive customer service.
Promote quality-training for Soldiers, Sailors, Airmen, Marines, and DoD employees to enhance adult learning.
Recommend approved equipment and training aids to conduct quality training.
1-4. Purpose of the Administrative Handbook
This handbook is a compilation of standards and administrative guidelines for training sites. AHA and ACS training program publications supplement this handbook. The MTN reserves the right to adapt AHA/ACS guidelines to meet the unique requirements of its personnel. All MTN affiliated training sites must adhere to the policies and procedures described in this handbook. Some of the material presented may be subject to interpretation. Contact the MTN if you have any questions concerning the handbook. The final interpretation authority is the MTN Director.
1-5. Structure of the Military Training Network
The MTN is organized under the DoD. The following diagrams illustrate the structure of MTN.
Fig 1-2: MTN’s relationship within the AHA Training Network.
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1-5. Structure of the Military Training Network (Continued)
The MTN staff is composed of Tri-Service Military: Air Force, Army and Navy and civilian personnel. They provide service specific expertise, quality assurance, worldwide coordination of training programs, and centralized record keeping.
MTN Director
The MTN Director is responsible for leadership and management of resuscitative and trauma medicine training programs for the uniformed services. The director, along with the appointed National Faculty (NF) and Committee on Trauma Chairpersons (COT) serve as the conduit between MTN affiliated training sites, AHA and ACS. The director ensures quality improvement of the MTN programs to include Staff Assisted Visits (SAVs) and ongoing course evaluations. The director oversees organizational and planning duties for MTN participation in national conferences to create and maintain partnerships with military and civilian professional organizations and national affiliating bodies.
MTN Non Commissioned Officer in Charge (NCOIC)
The NCOIC is the senior enlisted advisor to the MTN director as well as secondary point of contact for all programs. The NCOIC oversees the day to day operations of the MTN and the activities of the program managers.
MTN Program Managers
Program Mangers are the primary liaisons between the MTN and the training sites. They are NF administrative subject matter experts in the individual programs and provide oversight to training sites.
MTN Program Assistant
The Program Assistant manages correspondence, publications and directives. The Program Assistant provides comprehensive customer service and administrative support to the MTN.
National Faculty
The Surgeon General for each branch of service appoints MTN NF. The NF is the science based subject matter expert and represents the MTN on various AHA committees. Each service appoints a NF for each of the three Emergency Cardiovascular Care (ECC) programs. An individual may concurrently serve as the NF for more than one ECC program. NF appointments are ratified by the AHA and last for two years with one automatic re-appointment. Terms are limited to no more than four years in any one billet.
Committee on Trauma Chairpersons
The Region 13 Chief recommends ACS COT Chairpersons. They are subject matter experts and represent the MTN at various ACS meetings. There are three ACS COT billets. COT Chairperson appointments are endorsed by the ACS.
1-6. Training Sites
Training sites are affiliated organizations (e.g. military units or civilian departments) that conduct training programs. Training sites consist of the following components:
• MTN approved Training Site Faculty (TSF) or ACS COT Chairperson or designated faculty
• MTN approved Program Director or ACS Course Director
• MTN approved Program Administrator or ACS Course Coordinator
• Instructor cadre
• Administrative support
• All required teaching materials including textbooks
• All required teaching equipment as listed in the individual instructor manuals
• Adequate classroom space including secure equipment storage area(s). (Storage security for equipment is defined by individual service regulations)
1-7. Satellites
A satellite is a geographically separate (within 100 miles radius) training program that is supported by a designated Training Site (TS). A satellite cannot exist as a stand-alone affiliated site because it lacks one or more of the TS requirements previously listed. Satellites can conduct courses but rely on their TS for supervision, instructor support, materials, and/or equipment. The TS is responsible for maintaining copies of training records from courses taught at its satellite(s). Training sites and satellite programs may be from different organizations; hence, coordination between Commanders/Commanding Officers (or equivalent) is necessary to create and sustain the association. This can be achieved with a formal Memorandum of Understanding (MOU) between unit Commanders (or equivalent). The TS does not have to accept satellites; this usually is contingent upon TS resources and mission capabilities. Units or organizations interested in becoming a satellite may contact the MTN for assistance in locating nearby training sites or visit our website for lists of affiliated BLS/ACLS/PALS/PEARS sites. To locate a MTN affiliated TS, go to usuhs.edu/mtn and under “Quick Links” click on the relevant ACLS, BLS, or PALS, under “Sites Updated”.
1-8. Who May Participate in MTN Programs
The MTN provides mission essential training to DoD, US Coast Guard, US Public Health Service, and other US government personnel including active duty, Guard/Reservists (does not include IRR), DoD federal civilian employees, and foreign national employees. MTN affiliated training sites do not have open enrollment or provide training to the civilian community (with the exception of community outreach programs). In accordance with (IAW) MTN agreements with the AHA and ACS, persons who are not direct employees (e.g. military dependents, contractors, etc.) are not eligible for MTN sponsored training. Please note that civilian agencies or employers may not recognize MTN training and wallet cards.
Contractors
A contract employee is usually not eligible for training. A contract employee is only eligible if the contract stipulates that the purchaser (e.g., medical treatment facility) provides the training. The contract must stipulate the specific training (e.g., ACLS, BLS, PALS, PEARS) to be accomplished. A copy of the contract must be maintained with the Post Course Report (PCR). DoD standard contracting assumes the government is procuring a fully trained individual or service.
American Red Cross
The American Red Cross (ARC) is a sponsor/provider of basic resuscitative medicine training programs such as “Adult CPR/AED”. American Red Cross volunteers should first attempt to obtain training from their parent organization. If such training is not available, the TS may provide training to ARC hospital volunteers.
The TS Commander/Commanding Officer may provide training to otherwise non-eligible employees if the situation dictates. This is more likely to occur at overseas locations where no acceptable local training program exists. A Memorandum For Record endorsed by the TS Commander/Commanding Officer will be placed in the TS administration binder. Non-eligible personnel receive a locally generated course completion certificate instead of an MTN/AHA wallet card. The course of completion certificate cannot have the AHA logo due to copyright laws. MTN also recommends that the certificate should not have the word “certified”.
Chapter 2: Administration of Resuscitative Medicine Courses (ACLS, BLS, PALS, PEARS)
2-1. Introduction
The AHA publishes a Program Administrative Manual (PAM) that describes the management of its resuscitative medicine programs. The organizational structure of the MTN differs from other AHA Training Centers. These differences prevent an MTN TS from exclusively using the AHA PAM. Training sites adhere to the guidelines in this handbook. The AHA PAM is a supplemental reference and not required for TS management.
2-2. Administration of MTN Programs
The TS has appointed staff and a cadre of instructors that provide ECC courses. The TS receives administrative oversight from the MTN Program Managers and the MTN Director. MTN NF members provide expert guidance to the TSF. Below is the organizational structure for the MTN/AHA Programs.
2-3. Training Site Responsibilities
Training sites are organizations or offices that affiliate with the MTN in order to provide one or more of the AHA training programs. Training sites must possess all the criteria identified in Chapter 1 and be able to conduct an independent and self-sustaining training program. Training sites may support one or more satellite training units. The training sites’ role is to train persons in ECC programs and strengthen the Chain of Survival. Training sites are responsible for the following:
• The TS must use current AHA ECC training materials in its courses and ensure that course participants have the most current course materials for use before, during and after the course.
• The TS conducts instructor courses and updates it’s instructors with the latest information on AHA courses, science guidelines, policies and procedures, and training bulletins and memos.
• Hardcopies of the MTN Administrative Handbook are encouraged, but electronic versions are authorized. The electronic version of the handbook should be readily available and accessible.
• TS program administration, day-to-day management, and quality assurance of their ECC courses.
• Create and implement written, site specific policies and procedures that address the following (local policies must comply with MTN policies and standards):
- Quality assurance (to include course and instructor monitoring)
- Internal dispute resolution
- Equipment maintenance and decontamination
- Dissemination of instructor communications and updates
- Administrative records maintenance
- Card accountability, security, distribution, and destruction.
• Offer courses to all eligible personnel.
- Recruit an adequate number of instructors to meet the needs of its customers. In addition, provide an adequate number of courses each year to allow the opportunity for instructors to maintain/renew their instructor status.
- Train instructors in the proper use and care of Training Site specific training equipment. This training must be annotated in the instructor’s folder. Maintain a sufficient quantity of training equipment as outlined in the respective instructor manuals.
• Ensure equipment is decontaminated according to the manufacturer's instructions and/or the guidelines from the Centers for Disease Control. TS will maintain records of equipment decontamination. The “infection control” block on the PCR does not fully meet this requirement.
• Control and issue the AHA/MTN course completion wallet cards.
• Maintain course records and submit reports/correspondence by the suspense dates. Note: All PCR reports must be submitted to MTN within 30 days.
• Maintain instructor records and transfer departed instructor records to an MTN or AHA TS within 30 days of receiving a records transfer request from the gaining TS or departing instructor.
• Provide adequate support to designated satellite training locations. This includes conducting site visits to ensure program compliance.
• Support Chain of Survival initiatives in the local area at the discretion of the TS Commander/Commanding Officer. Examples include providing instructors, equipment, or organizational support to civilian programs/events.
• The MTN requires training sites to maintain internet access, valid contact information (i.e. TS telephone numbers, and email address for all TSFs, Program Directors, Program Administrators and instructors.
2-4. Training Site Documents
Each TS will maintain the following documents at their facility. The MTN requires a tabbed binder with the following sections and contents:
Section 1: Appointment letters (original or copy)
• Current training site affiliation memorandum; semi-annual/annual reports as applicable.
• Program Director, Program Administrator, and TSF appointment forms and applicable letters.
Section 2: Correspondence
• Maintain copies of MTN updates, policies, and procedures. Save all documentation on how information was disseminated to TS staff and instructors.
Section 3: Policies and Procedures (each TS must have a policy on the following areas)
• Equipment maintenance and decontamination.
• Quality Assurance Plan (to include course and instructor monitoring).
• Internal TS dispute resolution policy.
• Administrative records maintenance to include instructor folders and course reports.
• Card accountability, security, distribution, and destruction.
• Management of instructor communication and updates.
Section 4: Site Reviews
• Review checklists.
• Completed Self-Assessment reviews.
• Completed Administrative and Course Monitoring reviews.
• Documentation of corrective or follow-up actions.
Section 5: Current list of satellites and contact information (if applicable).
Section 6: Copies of local correspondence (e.g., memorandum and agreements).
MTN requires all training sites to maintain an individual folder for all qualified instructors with all required documentation.
2-5. Training Site Reviews
The MTN oversees a training site review program to promote quality assurance and process improvement. All training sites will complete a self assessment at least every two years.
The MTN conducts periodic SAVs to perform training site reviews and course monitoring. SAVs evaluate training site compliance with guidelines and allow the MTN to provide focused feedback, quality assurance and the opportunity for process improvement. SAVs also ensure compliance with MTN and AHA requirements. The MTN goal for SAVs is to visit a minimum of 10% of the affiliated sites per fiscal year. As an AHA Regional Training Center, the MTN has a trust relationship with the AHA to maintain the highest standards of resuscitative training. A training site’s refusal to cooperate or allow course monitoring and/or quality assurance review is grounds for termination of the TS affiliation. The MTN reserves the right to conduct no notice visits to its affiliated training sites. Information about the SAV/TS review program can be found in Chapter 7.
2-6. Affiliating with the Military Training Network
DoD, US Coast Guard and other US government organizations (by way of interagency agreements) are encouraged to request affiliation with the MTN. New affiliation requests are processed by an MTN Program Manager and reviewed by the MTN Director. All sites must be have a BLS program in place before applying for ACLS, PALS or PEARS affiliation, contact the MTN for additional assistance. The new program affiliation approval process takes approximately four to six weeks. This may take longer during the MTN reporting periods.
Eligible organizations and offices are encouraged to affiliate as a TS. Review and follow the guidelines in this chapter and the MTN webpage to prepare an affiliation request package. The package includes the following forms (see Appendix A and B):
• New Affiliation Request Form.
• Satellite List (if applicable).
• Projected courses for the upcoming fiscal year – ACLS and PALS (including PEARS) only. BLS sites should have a projected calendar for their internal use.
• An agenda for each type of projected course.
• Instructor List.
• Training Site Faculty Nomination Forms (if applicable)
• Program Director Nomination Form
• Program Administrator Appointment Form
• Equipment checklist signed by the Program Director and Program Administrator. (equipment checklist can be found on the MTN webpage)
E-mail/scan documents to: mtnreports@usuhs.edu. MTN requires all documentation to be transmitted electronically (e-mail). In rare circumstances when using a fax to transmit information to (DSN) 295-1717 or (COM) 301-295-1717. Please contact your Program Manager to verify receipt of any documents sent via fax. The coversheet should include the name of the facility, person sending the fax, number of pages and contact number.
• All correspondence submitted electronically (e-mail) to MTN must be named/identified by the sending unit/site. In the “Subject line”, note your training site/unit, MTN course i.e. BLS, ACLS, PALS/ the purpose and date of the email.
Examples:
- Subject: 00 MDG ACLS PCR 9SEP13
- Subject: USA MEDACC 123 BLS FY13 Semi-Annual Report 06June13
If necessary the MTN Program Manager will contact the facility to correct discrepancies on submitted documents. Additional documents must be submitted within five working days after contact. Upon approval the TS will receive the following:
• Affiliation memorandum
• Training Site Faculty Appointment wallet card for the Program Director (as necessary)
• Program Director and Program Administrator appointment memoranda
• Appropriate AHA/MTN course completion cards and examination materials
• Confirmation return receipt: Training sites will validate package contents and card quantities and email this receipt to the MTN
***Sites will not teach courses until the affiliation request is approved and THE TS receives the above materials.
2-7. Re-affiliation
Training sites must renew their affiliation (re-affiliate) annually no later than 30 Sep. This is accomplished by submitting an annual report and affiliation/re-affiliation packet. MTN strongly encourage classes to be completed by 15 Sep to allow PCR and annual report submission. MTN will accept packages starting 15 Sep. NOTE: All new affiliation packets will be processed in order received. Due to annual report processing there will be delayed processing for new affiliations.
2-8. Disaffiliation
A TS may be disaffiliated/terminated in one of three ways:
• The MTN or TS may terminate the affiliation without cause and close the TS with 60 days’ notice to the other party.
• Either party is free to choose not to re-affiliate however a written memorandum signed by the TS’s Commander/equivalent must be submitted to MTN. The memorandum should be submitted 30 days before re-affiliation period expires.
• Sites that fail to uphold their responsibilities or the policies of the MTN and AHA are placed on suspension. While in suspension, all training must cease. If corrective actions are not accomplished, suspension will lead to disaffiliation/termination from the MTN.
The TS that is terminated by MTN or requests disaffiliation is responsible for the following:
• The TS must notify its instructors in writing of the closing at least 45 days before the scheduled disaffiliation date or immediately if the training site is terminated by the MTN.
• The TS must provide instructors with a list of local MTN affiliated training sites.
• If the TS is choosing to disaffiliate, the site must submit a letter signed by the Commander (or equivalent) to the MTN Director announcing the disaffiliation.
• Return all blank course cards and program CDs to the MTN. Destroy all written examinations.
• Update and complete all course records
• Issue pending cards within 20 business days
• Submit an Annual Report
• Maintain records as described in the Section 2-14
• Instructor folders can be forwarded to another TS that is assuming responsibility for the closing site’s instructors and/or training mission. If there is no designated TS, then instructor folders should be issued to the respective instructors.
Training sites that have disaffiliated or been terminated must submit a new affiliation package in order to re-establish a training program at their facility. Training sites that are disaffiliated due to non-compliance or misconduct and wish to re-affiliate within 18 months of disaffiliation shall be required to fund an MTN SAV prior to approval.
Training sites that are disaffiliating due to unit closure should contact the respective MTN Program Manager for further instructions on the disposition of their records.
2-9. Temporary Hold
Active training sites that are in good standing may request that their TS status be placed on temporary hold for a period of up to 12 months. The TS must submit a memorandum requesting temporary hold to the MTN Director signed by the Program Director and endorsed by the Commander (or equivalent). Multiple reasons may exist for a unit to request temporary hold. For example, a unit may be on deployment orders with no intention of training while in theater, or a unit may no longer have the personnel to maintain the course but does not wish to disaffiliate. Units must be in good standing at the time of the request and must submit a completed annual report. While in temporary hold status, all training is suspended. The TS must request and be approved by MTN to resume teaching courses.
2-10. Dispute Resolution
It is the responsibility of the TS to manage and resolve any disputes, complaints, or problems that arise from a course offered by an instructor aligned with the TS.
The MTN is not responsible for the day-to-day operations of the TS or its business practices and will not become involved in the resolution of any disputes, complaints, or problems arising from courses taught by the TS unless one or more of the following is involved;
• Course content/curriculum
• Instructor qualifications
• AHA administrative policies and procedures
• AHA ECC science issues
• MTN TS agreement and program guidelines
If after diligent efforts, the TS is unable to resolve the dispute/complaint within 30 calendar days after being made aware of the problem, the TS must send a description of the dispute/complaint to the MTN in writing. All complaints must contain the following information:
• The name and address of the person making the complaint. Complainants may not remain anonymous.
• The name and address of the person and/or organization against which the complaint is made.
• A detailed written description of the dispute, complaint, or problem (who, what, when, where, and why). For TS related issues, the complaint should contain information on attempts of the TS to resolve the matter. The Program Director must sign the statement.
• Reference to the appropriate rule, standard, and/or guidelines related to the matter.
• Copies of all related correspondence, records and other documentation.
Complaints about the issues listed above may be submitted to the TS by:
• A student who attended the course in which the problem arose
• An instructor, Program Administrator, Program Director, TSF
• Any staff member with information about the problem
The MTN will review all submissions and report back to the parties in regards to the official determination IAW AHA policies and guidelines. The MTN Director is the final approval authority for all actions resulting from the dispute resolution when elevated to the MTN level.
2-11. Request for Additional Cards
If a TS will deplete its supply of course completion cards before the end of the semi or annual report period, the TS will send an additional card request form to the respective Program Manager requesting additional cards. Both the Program Director and Program Administrator must sign the additional card request form (Appendix A and B). No additional cards will be sent within 45 days of semi- or annual report submission due dates. No additional card requests will be accepted during the reporting period until the unit’s report is completed and approved by the MTN Director. Once the unit’s report is completed and approved, a TS may then submit a card request if needed.
2-12. Reciprocity
National Faculty: MTN NF appointees are branch of service specific and do not have reciprocity as AHA Regional. NF may function as an instructor at any MTN or AHA training site. In addition, NF must be appointed as TSF.
Training Site Faculty: TSF appointments are MTN specific and therefore these individuals do not have reciprocity to other AHA programs. TSF may function as an instructor at any MTN or AHA TS. When a TSF changes station, their TSF status may be continued by the gaining Program Director. If a TSF appointment is discontinued, then an instructor card is issued (with the dates from the TSF card), and a memorandum stating the reason for discontinuing the TSF status is placed in the instructor’s training folder.
Instructor: MTN/AHA instructors have reciprocity and may function as an instructor at any MTN or AHA TS. The MTN encourages instructors to participate in community based training programs. When an instructor changes station or training site alignment, the gaining TS staff must initially orient and monitor the instructor. An MTN instructor who wishes to teach outside of MTN must align with a civilian training center and meet its affiliation requirements.
MTN Provider Cards: MTN provider cards for AHA courses are the equivalent of the corresponding AHA provider card. MTN provider cards should be recognized by AHA training centers and training sites when renewing DoD personnel.
American Red Cross Instructor Certificates/Cards: ARC CPR instructors can become AHA instructors by completing the following:
• Must present a valid ARC provider card or ARC instructor card
• Align with an MTN BLS TS
• Complete the discipline-specific AHA Instructor Essentials Course
• Complete the AHA 2010 guidelines science instructor update course (BLS or Heart saver)or any other necessary AHA updates.
• Complete the BLS or Heart saver instructor course
• Competently demonstrate skills performance
• Successfully teach an AHA Course monitored by TSF from the TS with which the instructor is affiliating (or the TS that conducted the AHA instructor training) within 90 days of completing the instructor course.
• Upon completion of the above requirements the TS will issue the appropriate instructor card with the date when these requirements were completed.
• There is no direct conversion from ARC instructor to AHA instructor.
• A person who holds dual instructor status and wishes to maintain them must satisfy the requirements of both organizations.
2-13. Instructor Records
Training sites must maintain an instructor folder for each instructor. Instructor folders will consist of a two part folder with top fasteners. Four or six part folders may be utilized for multi-discipline instructors. If four or six part folders are utilized, the folder will be assembled as listed below with each discipline occupying its own two part section.
Left side of instructor folder in order from top to bottom in chronological order with the most recent form on top and grouped with like forms.
• Instructor teaching activity log (include course type, date, and location)
• Curriculum Vitae (CV) for TSFs and PDs
• Copies of additional certifications, licensures, and other training documentation indirectly related to MTN Resuscitative Medicine Training. For example, NREMT-P, RN, Respiratory Therapist. These items are only necessary if the individual is also being utilized as a “subject matter expert”.
Right side of instructor folder in order from top to bottom in chronological order with the most recent form on top and grouped with like forms:
• TSF/Program Director appointment form.
• Instructor renewal checklist
• Instructor monitoring form(s).
• Instructor candidate form.
• Copy of signed wallet card (front and back).
• Memorandum(s) or certificates of training for in-services and any additional training directly related to MTN resuscitative medicine programs for example; memorandums with both Program Director and instructor’s signatures for equipment and decontamination training, discipline-specific AHA Instructor Essentials Course, core instructor course, and current AHA guidelines update attendance.
Instructors should obtain a copy of their file prior to Permanent Change of Station or separating from the service or current place of employment. Upon written request, training sites will transfer original instructor records to other MTN or AHA sites. The MTN recommends maintaining instructor folders of inactive instructors until the end of the instructor’s certification period. However, the TS may destroy inactive instructor files at the end of the fiscal year following annual report submission. Training sites will not be required to maintain instructor folders more than 24 months from the date that an instructor separates from the TS. Instructor folders will be disposed of in the same manner as “For Official Use Only” documentation. Refer to respective service regulatory guidance.
Prior to issuing an instructor folder to a departing instructor the TS must verify that all documentation is included in the instructor’s folder and that all courses have been annotated on the teaching activity log.
2-14. Maintenance of Course Records
TS records can be stored electronically or as a hard copy. To protect against a possible loss of records, all electronic files must be backed up on a regular basis. All electronic files must be capable of printing as hard copy and possess a signature as required. The TS must be able to produce/print out a hard copy upon request.
Records and backed-up files from all MTN sponsored training must be stored at the TS for three years. Training sites with satellite units must devise a records storage plan acceptable to both the TS and the satellite units and includes the following:
• Original course records to include annual and semi-annual reports are maintained for at least three years by the TS. These records will be available at one location during any TS review or site visit.
• Any record copies or summaries provided to the TS in lieu of the originals must be maintained by the TS for the three years.
• The MTN will maintain all annual reports for a minimum of three years. Local training sites are no longer required to maintain records for greater than three years.
• If a satellite is closed, the TS will assume responsibility for maintaining all satellite records to comply with the three year requirement.
Lost cards and card replacement: To obtain and/or replace a lost MTN course completion card the individual will be issued a replacement card only by the MTN-affiliated site where the training was received. Cards due to expire within four months will not be replaced with a new card. TS can issue a temporary approval letter that can be utilized locally. A new card will be issued upon course completion.
2-15. Continuing Education Credit
The MTN no longer offers continuing education (CE) credit for advanced courses. Training sites can acquire CE for ACLS, PALS and PEARS courses by applying directly to their respective branch of service CME/CNE office(s). Contact information is available on MTN’s website in the Memos section. Contact the POC(s) for application requirements.
This change only applies to CE. All other MTN/AHA guidance remains in effect, including but not limited to, MTN affiliation/re-affiliation requirements, course conduct, documentation, course records, and compliance. All ACLS and PALS Training Sites are still required to submit post course reports to MTN within 30 days of course completion for all courses, both CE and non-CE sites, and regardless of who provides the CE.
The MTN course evaluation form is mandatory in addition to any course evaluation required by the respective service CE office. The current form is available on MTN’s website and reflects AHA required content. With the CE provider’s concurrence, the TS may incorporate these questions into their form(s).
2-16. Electronic Communications
The MTN employs electronic systems and the internet to improve services. The MTN requires Program Directors and Program Administrators to have internet access and a valid e-mail address on file with MTN. Notify the MTN as soon as possible if your contact information changes. Visit MTN’s webpage to obtain the latest information, updates, news, and forms. Program Directors and all instructors are expected to register with the AHA Instructor Network (IN) . Training sites who cannot access the IN should contact MTN for guidance.
2-17. Revoking Instructor Status
Grounds for Revocation
Revocation of instructor status may only occur as a result of the findings of a dispute resolution. The following are reasons for revocation (this list is not all inclusive):
• Falsification of class records
• Non-adherence to MTN and/or AHA guidelines and curricula
• Producing or issuing non-AHA/MTN course completion cards
• Continued instruction that is inconsistent with AHA standards for the course/program after remediation by the TS, MTN staff, or NF
• Using non-AHA examinations, mishandling or breaching security of AHA exams
• Teaching/proctoring courses outside of the instructor’s discipline
• Teaching without current certification for the specific course (instructors must meet all qualifications to teach within their discipline)
• Inappropriate activities, language, harassment, or conduct during courses or directed toward other instructors, students, or TS staff.
The TS Program Director has the authority to revoke an instructor’s association with the TS. Upon revocation, the TS must notify the MTN Director through the respective Program Manager. The MTN Director will determine whether the instructor is eligible for active status or should have his or her instructor status revoked.
• The MTN Director is the approval authority in the revocation of an instructor's teaching credentials (wallet card).
• If an instructor card is revoked, a provider card is issued by the responsible TS, unless the instructor obtained the provider card without meeting the curriculum requirements, i.e., not completing all required skills and tests or cheating.
• A memorandum outlining the revocation action is placed in the instructor’s TS folder and a copy is forwarded to the MTN along with a copy of the revoked instructor card. Instructor cards must be returned to the responsible TS for destruction.
2-18. Emergency Cardiovascular Care Courses available through the MTN
|BLS |ACLS |PALS |
|Discipline Specific Instructor Essentials Course |
|Heartsaver CPR AED |Advanced Cardiac Life Support – Provider |Pediatric Advanced Life Support – Provider |
| | | |
|BLS for Healthcare Providers |Advanced Cardiac Life Support - Instructor |Pediatric Advanced Life Support – Instructor |
| | | |
|BLS Instructor | |Pediatric Emergency Assessment, Recognition, and Stabilization |
| | |(PEARS) |
|Heartsaver Instructor | | |
| | |PEARS - Instructor |
2-19. Computer Based Training (CBT) /eLearning Systems
Healthcare Provider Renewal
MTN authorizes the utilization of the AHA BLS for HCP Online Part 1 and Heartcode BLS Part 1 Courses for renewal only. MTN training sites will adhere to the following guidelines:
• Participants must present a valid BLS HCP online renewal certificate and valid BLS HCP wallet card in order to enroll in the psychomotor skills evaluation.
• Students are required to complete the skill check within 30 days of completing the online didactic portion and printing of their certificate. The TS will make every effort to complete the skills check in a timely fashion and have the flexibility to conduct the skill check in a manner that best fits their facility and resources. In general there are two approaches:
- Skills check during a traditional classroom based BLS HCP course. In this approach add the BLS HCP online (OL) student(s) to the course roster and annotate “OL” for BLS HCP online in the “written exam” column of the MTN BLS PCR. Document the outcome of the skills check in the “skills and evaluation stations” column. Attach a copy of the BLS HCP online certificate that confirmed the student(s) completed the computer-based portion to the MTN BLS PCR.
- Stand alone skills check. In this case the TS will generate a MTN BLS PCR. Complete the grade report and attach BLS HCP Online certificate(s) as described above. Rather than creating a separate PCR on each day that skills checks occur, the TS may accomplish one PCR that includes all skills checks in a calendar month. Remember to add every instructor to the instructor roster. Monthly BLS HCP online PCRs must be closed out at the end of each calendar month.
• Training sites will issue an MTN BLS HCP course completion card to eligible students who successfully complete the skill assessment.
• Additional guidance for the student practice (Part 2) and testing (Part 3) can be found in the instructor manual.
ACLS Renewal
MTN authorizes the utilization of the AHA Heartcode ACLS Part 1 Course for renewal only. MTN training sites will adhere to the following guidelines:
• Participants must present a valid AHA Heartcode ACLS Part 1 online renewal certificate and valid ACLS and BLS HCP wallet cards in order to enroll in the psychomotor skills evaluation. Individuals whose card has expired between the time of online completion and skills evaluation will be allowed to complete the skills check.
• Students are required to complete the skills check within 30 days of completing the online didactic portion and printing of their certificate. Training sites will make every effort to complete the skills check in a timely fashion and have the flexibility to conduct the skill check in a manner that best fits their facility and resources. In general there are two approaches:
- Skills check during a traditional classroom based ACLS course. In this approach add the Heartcode ACLS Part 1 online student(s) to the course roster and annotate “OL” in the “written exam” column of the MTN ACLS PCR. Document the outcome of the skills check in the “skills and evaluation stations” column. Attach a copy of the Heartcode ACLS Part 1 online certificate that confirmed the student(s) completed the computer-based portion to the MTN ACLS PCR.
- Stand alone skills check. In this case the TS will generate a MTN ACLS PCR. Complete the grade report and attach the Heartcode ACLS Part 1 online certificate(s) as described above. Rather than creating a separate PCR on each day that skills checks occur, the TS may complete one PCR that includes all skill checks in a calendar month. Remember to add every instructor to the instructor roster. Monthly Heartcode ACLS Part 1 PCRs must be closed out at the end of each calendar month.
• TS will issue an MTN ACLS wallet card to students who successfully complete the skill assessment.
• Additional guidance for the Heartcode ACLS student practice Part 2 and testing Part 3 can be found in the instructor manual.
PALS Renewal
MTN authorizes the utilization of the AHA Heartcode PALS Part 1 Course for renewal only. MTN training sites will adhere to the following guidelines:
• Participants must present a valid Heartcode PALS Part 1 online Renewal certificate and valid PALS and BLS HCP wallet cards in order to enroll in the psychomotor skills evaluation. Individuals whose card has expired between the time of online completion and skills evaluation will be allowed to complete the skills check.
• Students are required to complete the skills check within 30 days of completing the online didactic portion and printing of their certificate. Training sites will make every effort to complete the skills check in a timely fashion and have the flexibility to conduct the skills check in a manner that best fits their facility and resources. In general there are two approaches:
- Skills check during a traditional classroom based PALS course. In this approach add the Heartcode PALS Part 1 online student(s) to the course roster and annotate “OL” in the ‘written exam” column of the MTN PALS PCR. Document the outcome of the skills check in the “skills and evaluation stations” column. Attach a copy of the Heartcode PALS Part 1 online certificate that confirmed the student(s) completed the computer-based portion to the MTN PALS PCR.
- Stand alone skills check. In this case the TS will generate a MTN PALS PCR. Complete the grade report and attach the Heartcode PALS Part 1 online certificate(s) as described above. Rather than creating a separate PCR on each day that skills checks occur, the TS may complete one PCR that includes all skills checks in a calendar month. Remember to add every instructor to the instructor roster. Monthly Heartcode PALS Part 1 PCRs must be closed out at the end of each calendar month.
• TS will issue an MTN PALS wallet card to students who successfully complete the skills assessment.
• Further guidance for the Heartcode PALS student practice Part 2 and testing Part 3 can be found in the instructor manual.
Additional Computer Based Training: The MTN will issue written guidance as to the reporting procedures and applicability of each program when additional training becomes available. In the absence of written guidance, contact the respective MTN Program Manager for guidance.
2-20. MTN Course Criteria
An MTN/AHA ECC course must meet the following criteria before a course completion card may be issued.
• The course instructor(s) must be a current MTN/AHA recognized instructor. Specialty Faculty with expertise in a particular content area may assist MTN/AHA instructors in advanced life support courses. Any courses conducted with the assistance of an expired instructor will be considered null and void and all personnel having attended will be required to attend a course at a later date. All cards issued will be voided and collected by the Program Administrator and/or Program Director.
• The course must be taught according to the guidelines and core curriculum set forth in the most current editions of the AHA course textbook(s) and/or Instructor Manuals.
• Each student must have the current appropriate course textbook readily available for individual use before, during, and after the course.
• The most current edition of AHA course materials, videos, and exams must be used.
• A MTN approved course evaluation must be used in each MTN/AHA course to obtain feedback from students on course content and instructors.
• After successful course completion, the appropriate MTN/AHA course card or certificate of training (as appropriate) will be issued.
• The following guidelines apply to provider course faculty:
- MTN/AHA courses must be taught by AHA instructors with current instructor status in their specific discipline.
- Specialty Faculty (e.g., an anesthesiologist who teaches airway management) may assist in teaching advanced-level courses (ACLS, PALS, and PEARS) at the discretion of the Program Director. They must hold current provider status in the discipline being taught. They do not test students or participate in the testing process. Refer to the applicable instructor manual.
- Specialty Faculty do not count in the required student-to-instructor ratio as outlined in the appropriate instructor manual.
- The Program Director is responsible for monitoring Specialty Faculty in every course in which they teach to ensure they follow AHA guidelines.
- An AHA Instructor of the appropriate discipline must conduct the formal assessment and testing of students.
2-21. Skills Testing
Skills testing will be conducted per applicable AHA instructor manual and/or updated releases from the AHA and/or MTN. Only current skills tests will be used to determine successful course completion.
Skills tests are a primary determinant of the student’s success in the mastery of the course material. The instructor must:
• Administer these tests as designated and outlined in the applicable curriculum, without
prompting the student. Prompting and coaching students during testing undermines the
purpose of the evaluation and the student’s confidence in his or her ability to perform the required skill.
• Use the skills test sheets as described in the curriculum. Completed sheets for students who haven’t succeeded in performing the skill will be kept in the course file.
2-22. Written Examinations
Written examinations may not be altered in any way or posted to any internet or intranet sites. This includes pre-course exams. Any concerns regarding specific questions or answers may be referred to the respective Program Manager. The most current tests are the only authorized tests to be used for determining successful course completion. Use of any other written test to determine a student’s completion of an MTN course will jeopardize the TS affiliation, the instructor’s status, or both.
The written test measures the mastery of cognitive skills. Each student must take the written test without using the student manuals or any other resources for assistance.
Any algorithms on display in the testing room must be covered during the test.
Students may not cooperate with or talk to each other during the test.
Examinations should be graded immediately upon completion. The use of group grading is not authorized. Examinations must be graded by an instructor. Program Administrators will not grade examinations unless they are currently certified in the respective program at a minimum of provider level.
To accurately measure students' understanding of the course material, the written examination is given individually in a proctored setting. Students must score 84% or higher on the written examination for course completion. If a student scores less than 84% on the written examination, he or she receives remediation and takes a different version of the examination. Students failing the written exam for the second time in the same course will be required to attend a complete course at a later date.
2-23. Remediation
Instructors must provide remedial training to students. The goal of remediation is to resolve an identified cognitive or psychomotor weakness.
If a student fails to pass a skills test, an instructor will work with the person during the remediation lesson at the end of the course and retest the student at that time. Students will be retested in an entire skill rather than just the missed item.
Students who, after remediation, receive an “unsuccessful” grade in one or more of the course evaluation components will not receive a course completion wallet card. These individuals will be required to attend and successfully complete an entire course at another date in order to receive a course completion wallet card.
2-24. Instructor to Student Ratio
Basic Life Support
The course size for all MTN sponsored BLS courses is flexible and dependent on availability of space, instructors, and equipment. The following are the maximum allowable ratios for MTN sponsored BLS courses.
|BLS |
|Student to Instructor |6 to 1 |
|Student to Manikin |3 to 1 |
|Manikin to Instructor |2 to 1 |
Advanced Cardiac Life Support
Students enrolled in an ACLS course varies and usually depends on the facility, number of instructors, and available equipment. The following are the maximum allowable ratios for MTN sponsored ACLS courses.
|Advanced Cardiac Life Support |
|Large-Group Interactions |The size of the group is limited by the size of the room and the number of video monitors or |
| |projection screens. |
|Learning Stations and Mega code testing |The student-to-instructor ratio is 6:1 |
Pediatric Advanced Life Support
Students enrolled in a PALS course varies and usually depends on the facility, number of instructors, and available equipment. The following are the maximum allowable ratios for MTN sponsored PALS courses.
|Pediatric Advanced Life Support |
|Large-Group Interactions |The size of the group is limited by the size of the room and the number of video monitors or |
| |projection screens. |
|Skills Stations and Learning Stations |The student-to-instructor ratio is 6:1 |
|PALS core case testing |The student-to-instructor ratio is 6:1. Each student is tested as a team leader while the other |
| |students perform various team roles. |
| BLS Station | The student-to-instructor ratio should be 6:1, with a student-to-manikin ratio of 3:1. |
Pediatric Emergency Assessment Recognition and Stabilization
Students enrolled in a PEARS course varies and usually depends on the facility, number of instructors, and available equipment. The following are the maximum allowable ratios for MTN sponsored PEARS courses.
|Pediatric Emergency Assessment, Recognition, and Stabilization |
|Large-Group Interactions |The size of the group is limited by the size of the room and the number of video monitors or |
| |projection screens. |
|BLS Competency Testing Station |The student-to-instructor ratio is 6:1, with a student-to-manikin ratio of 3:1. |
|Skills Stations and Learning Stations |The student-to-instructor ratio is 6:1. |
2-25. Renewal
Provider- (BLS, ACLS, and PALS): Providers can renew in one of three ways:
• Option 1: Attend a renewal course. In order to attend the renewal course students must possess a current provider card. Individuals who have allowed their provider card to expire will be required to attend an initial provider course.
• Option 2: Attend a full provider course.
• Option 3: Become an instructor in the respective discipline.
The renewal date for all AHA provider courses is two years.
Instructor- (BLS, ACLS, and PALS) Instructors renew their teaching credentials in one of the following two ways:
Option 1 four required components
• Maintain current provider status as evidenced by a current provider card or demonstration of acceptable provider skills and successful completion of the provider written exam. Document provider status on the Instructor Renewal Checklist and maintain this form in the instructor’s file. If the instructor chooses the demonstration route, a new provider card may be issued at the discretion of the TS or upon request of the instructor but is not required by the AHA or MTN.
• Earn four credits by doing any combination of the following:
- Teach a minimum of four classroom provider courses or provider updates or renewals in two years for the discipline in which the instructor is renewing
- Conduct skills practice and testing sessions for eLearning courses. Each day of skills practice and testing sessions counts as one of the required four courses; all four credits can be earned this way.
• Attend updates as required within the previous two years. Updates may address new course content or methodology and review TS, MTN and/or national ECC information.
• Receive a successful instructor monitoring evaluation from a TSF before instructor status expiration. The first monitoring after the initial Instructor Course does not satisfy the renewal requirement. The TSF must formally monitor each instructor at least once every two years or upon reassignment to a new training site. If a deficiency is noted during monitoring, the TSF may conduct one-on-one remediation or advise the candidate to repeat the Instructor and/or Provider Course.
Option 2: Complete an entire instructor course
• The instructor course must include monitored teaching performance within 90 days of completing the instructor course. If a deficiency is noted during monitoring, the TSF may conduct one-on-one remediation or advise the candidate to repeat the Instructor and/or Provider Course.
If renewal criteria are not satisfied within the card expiration period, the instructor must complete an instructor course, to include the Instructor Essentials Course.
The renewal date for all AHA instructor courses is two years.
2-26. Challenge Option
Challenge Option: The MTN authorizes the use of the challenge option for BLS Healthcare Provider renewal only. A “challenge” occurs when a student requests to complete course testing requirements without participating in an AHA classroom or online course. This option IS NOT authorized for MTN’s ACLS and PALS Training Sites.
Challenge Guidelines
Instructors must follow all course testing requirements as defined in the AHA BLS Instructor Manual.
Students cannot challenge a course after one year of release date of corresponding product materials. The only exception is for an instructor updating his or her provider card if the instructor has completed the most current required science updates.
Students must show their current MTN/AHA course completion card before testing. An expired MTN/AHA course completion card is not acceptable.
Students must show the instructor that they have the appropriate and current course AHA BLS Student Manual.
All testing must be performed by a BLS instructor in current standing.
There is no option for practice or coaching.
The challenge testing must be done as a separate session and cannot be associated with a skills session from a classroom-based provider course or Part 3 of a blended-learning course.
The challenge testing must be performed with a 1:1 student-to-instructor ratio.
The testing session will be stopped at the first point the student fails.
No remediation is allowed in the challenge option. A student may not reattempt the challenge testing.
If the student fails the challenge testing, no card will be issued by the TS, and the student should be scheduled to attend a full provider course.
A PCR must be completed, regardless of whether the student passes or fails.
NOTE: Due to the nature of challenge testing, only BLS TSF and very experienced instructors will conduct the testing. No testing will be done without the BLS Program Director’s prior approval. The Program Director is responsible for compliance with MTN/AHA guidance.
2-27. Deployed Personnel
Due to the nature of prolonged military operations, deployed personnel may be unable to attend or teach MTN courses (including BLS, ACLS, and PALS). The MTN recognizes that deployed personnel will return to their home station after the renewal date or expiration date indicated on the MTN course completion wallet card. This section provides guidance and is intended to help training sites expedite renewal.
Renewal of Provider Status
Program Directors should develop a plan and make every effort to ensure individual qualifications will not expire while the member is deployed. Personnel who will lapse or expire while deployed or performing temporary duty should complete a renewal course within 90 days prior to deployment.
Personnel should enroll in refresher or renewal courses. Training sites that do not already offer renewal courses are encouraged to develop them. In addition, flexible course scheduling, adding additional courses, and one-on-one training sessions should be considered.
In the event that an individual expires while deployed, individuals must complete renewal training within 60 days of return. Follow service specific guidelines/regulations.
Renewal of Instructor Status
Program Directors should develop a plan and make every effort to ensure instructor’s qualifications will not expire while the member is deployed. Expired instructors are required to renew by completing requirements found in the Section 2-25 above within 60 days of return. Instructors must be monitored while teaching a course. The Program Director may waive the requirement to teach four courses in two years provided the instructor is recommended for renewal as documented on the Instructor Monitoring Form.
Expired instructors unable to meet the renewal requirements will lose instructor status and should be scheduled to attend a provider course.
Consideration in Performance of Duties
The employer, supervisor, or credentialing official determines if personnel with expired training may perform duties (e.g. patient care). The American Heart Association states “course completion in no way warrants performance, guarantees future actions, qualifies or authorizes a person to perform any procedure, and is unrelated to licensure.” without any conflict with directive or local policy, the MTN recommends extending the BLS, ACLS, PALS renewal or expiration date 60 days from the date of the deployed unit return to home station to support training and recertification of deployed personnel. The employer, supervisor or credentialing official will submit a memorandum of record for approval to the commander/commanding officer or equivalent for approval. Once signed, the memorandum will be maintained on file by the Program Director.
2-28. AHA Instructor Essentials Online Courses (discipline-specific)
The AHA developed new instructor course materials that will aid in providing quality and consistency in all instructors training. The Instructor Essentials course replaces the Core Instructor Course. Only the current AHA approved course material will be used for conducting all AHA Instructor Courses. Each instructor course has three discipline-specific components:
• Instructor Essentials online course
• Classroom-based instructor course
• Course monitoring
The steps for becoming an AHA Instructor are:
• Align with an AHA/MTN TS and have a completed instructor candidate application to file with that TS.
• Hold a current AHA provider status in the discipline for that instructor course.
• Be proficient in all the skills of that discipline.
• Successfully complete the discipline-specific Instructor Essentials Online course and print the certificate of completion.
• Successfully complete the discipline-specific instructor course.
• Be monitored teaching their first course within 90 days of completing the discipline-specific classroom instructor course by the Program Director or a TSF (Program Director can require additional monitoring if needed).
The following groups must complete an AHA Instructor Essentials Course:
• All Program Directors, TSF and NF
• All new instructor candidates
• Instructors who are adding a discipline (e.g. BLS instructor adding ACLS instructor status)
Program Directors, TSF and NF must complete the discipline-specific Instructor Essentials Course before teaching their first course with new materials or performing any course monitoring for courses taught using the new materials.
2-29. Infection Control
Equipment Decontamination
Training sites will establish a method of cleaning all training equipment that meets AHA and Centers for Disease Control (CDC) requirements. This will consist of a written policy for decontamination of equipment before, during and after courses. Training sites will also develop and utilize a tracking mechanism to ensure compliance.
Exposure
Neither participants nor instructors will participate in resuscitative medicine training if they are known to be in the active stages of an infectious disease, have reason to believe they have been exposed to an infectious disease, or have dermatologic lesions on their hands, the area of the face around the mouth or encircling the mouth.
2-30. Equipment Familiarization Training
The TS must conduct training for its instructors on course equipment used within the facility. Equipment familiarization and decontamination training will be documented, signed by the Program Director and instructor, and maintained in the instructor’s folder.
CHAPTER 3: POSITION DESCRIPTIONS, DUTIES AND RESPONSIBILITIES
3-1. Training Site Responsibilities
Educational objectives must be met according to the guidelines in the respective AHA instructor manual. All core course content must be included.
The AHA instructor materials include lesson maps to help facilitate courses. The lesson maps help ensure consistency from course to course and help keep the instructor focused on the main objectives for each lesson. Deviation from published lesson plans is not authorized.
Courses must adhere to the student-to-instructor and student-to-manikin ratios outlined in Chapter 2.
Students must participate, practice and successfully complete all requirements to receive a MTN wallet card.
Successful course completion is achieved when a student meets the course cognitive and psychomotor objectives.
Instructors will use remediation techniques to help a student achieve course completion.
Students are evaluated using the most current version of the AHA examination materials. The MTN Program Managers provide testing materials to the training sites.
Students must demonstrate competency without any assistance, hints, or prompting.
3-2. Training Site Staff
Program Director
The Program Director is responsible for all aspects of their respective MTN program at the TS. The Program Director is an experienced TSF. The Program Director is nominated by the Commander/Commanding Officer and appointed by the MTN Director.
Program Director Responsibilities
Implement and manage the respective training program in accordance with AHA and MTN guidelines.
Utilize approved course agendas tailored to TS requirements that include all core AHA content.
Notify the MTN of problems, disputes, or other concerns.
Ensure the appropriate records and reports are maintained at the TS and forwarded to the MTN by the suspense dates.
Maintain adequate training resources (e.g. space, textbooks, equipment, and supplies).
Ensure the TS has a minimum of two TSF. Program Director must plan accordingly to develop and groom TSF to meet this requirement. The TS is required a ratio of one TSF per fifteen instructors (ratio 1:15).
Overall responsible and accountable for MTN wallet cards and test materials. Any excessive mishandling or misuse of MTN wallet cards must be reported to the Commander/Commanding Officer and the MTN. An investigation will be conducted at the TS unit’s expense. Intentional mishandling or misuse of MTN wallet cards constitutes Fraud, Waste and Abuse.
Review the files of all newly assigned TSFs and instructors; provide TS specific orientation.
Coordinate the monitoring of newly assigned TSFs and instructors during the first teaching occurrence; and address any discrepancies or concerns.
Report changes of TS staff (Program Director and/or Program Administrator) to the MTN in writing within ten business days.
Coordinate and ensure adequate turnover for all TS staff changes.
Conduct course monitoring reviews at any TS and/or satellites in order to support quality assurance within the MTN.
Review and sign all post course reports.
Teach instructor/provider courses and fulfill TSF renewal requirements.
Appointment Criteria
Hold a current MTN TSF in the respective program. If the individual is not a TSF at the time of nomination, a TSF nomination must be submitted to the MTN with the Program Director nomination packet. Refer also to Section 3-2 on TSF appointment.
Has at least two-year’s experience as an instructor or has taught at least a minimum of four courses, and one required instructor course within the last two years. All courses taught must be within the discipline in which the member is trying to achieve TSF status in.
Cannot be the same person as the Program Administrator.
Complete the MTN Program Director nomination form (see Appendix A and B) to include appropriate signature blocks and signatures. If the candidate has not met all the Program Director requirements, a waiver request may be submitted. Attach a memorandum, endorsed by the Commander/Commanding Officer, justifying the request. The Program Manager will review all waivers on a case-by-case basis and make recommendations to the NF and MTN Director.
Based on service specific OPTEMPO, an interim Program Director may be authorized at MTN’s discretion. TS will submit a Program Director nomination packet to MTN and follow appointment criteria outlined in Chapter 3.
Appointment Length
Program Director appointments are TS specific and do not transfer with the individual. Length of the appointment is at the discretion of Commander/Commanding Officer.
Nomination packages to replace a Program Director must be received by the MTN NLT six weeks prior to the incumbent’s departure to allow time for processing.
The MTN Director is the renewal authority for a Program Director’s TSF card.
The Program Director must maintain a current TSF card.
Training Site Faculty
The TSF is the subject matter expert for the respective ECC program and is appointed by the TS Program Director.
The TSF candidate must be highly motivated, well trained, and an experienced instructor.
TSF must lead teaching activities and are charged with training, mentoring, and evaluating courses and instructors.
Each TS must have a minimum of two TSF. Training sites should plan accordingly to develop and groom TSF to meet this requirement. Training sites require a ratio of one TSF per fifteen instructors (ratio 1:15).
The TS should maintain an adequate number of TSF to ensure program continuity.
Training Site Faculty Responsibilities
Serve as quality assurance and educational leader for the TS and notify the MTN of problems, disputes or other concerns.
Conduct instructor courses and monitors, updates and mentors instructors.
Facilitate planning, program implementation and quality assurance.
Teach and support instructors during provider courses. TSF must be available to assist the course director/lead instructor if necessary.
Mentor and develop course directors and TSF candidates.
Evaluate and recommend new TSF candidates.
Training Site Faculty Appointment Criteria
Be a current MTN instructor in the respective discipline (BLS, ACLS. PALS). Heartsaver instructors and PEARS instructors cannot be TSF’s as they are laymen courses and therefore not overall subject matter experts of the respective discipline (BLS, PALS).
Has two-years of experience as an instructor or has taught at least a minimum of four provider courses and one instructor course within the last two years. All courses taught must be taught within the discipline the member is trying to achieve TSF status in.
Served as either a course director or lead instructor for at least one course in their respective discipline.
Assisted in teaching at least one instructor course under the supervision of a TSF.
Identified as having TSF potential in an instructor course and demonstrated TSF potential during a screening evaluation.
Demonstrated exemplary performance of provider skills under the observation of a current TSF or the Program Director.
Waiver requests for above requirements may be submitted by TS Commander/Commanding Officer to the MTN Director for consideration of extenuating circumstances. The Program Director may not waive requirements for TSF he/she appoints.
Must have completed the discipline-specific AHA Instructor Essentials course.
Re-appointment Criteria
Meet all requirements for instructor renewal as outlined in Chapter 2.
Teach a minimum of four provider courses and one required instructor course within the previous two years. All courses taught must be taught within the discipline the member is trying to renew their TSF status in
Waiver requests for above requirements may be submitted by TS Commander/Commanding Officer to the MTN Director for consideration of extenuating circumstances.
Complete the TSF Nomination Form IAW Appendix B of this manual.
Length of Appointment
TSF appointments are for two years unless revoked by the MTN, TS Program Director, or TS Commander/Commanding Officer.
TSF appointments transfer with the individual.
When a TSF arrives at a new TS, the TSF must be oriented to the local procedures, have their file reviewed by the Program Director and be monitored at the first teaching occurrence with the monitoring form (Appendix A) placed in their file. The receiving Program Director has the right to either accept or reject incoming TSF. If a Program Director refuses to accept a TSF they will issue the individual an instructor card or provider card in place of the TSF card. A memorandum will be placed in the individual’s file detailing the reason for the action.
Instructor
All instructors are responsible for the items listed below; typically the course director /lead instructor for a given course will be held accountable for compliance.
• Ensure students receive adequate instruction of all course material.
• Evaluate and remediate student performance as necessary.
• Set-up and disassembly of training equipment. This task may be assigned to other personnel within a given training site, but it is the instructor’s responsibility to ensure the presence, serviceability and accountability of all equipment necessary to conduct the respective course.
• Ensure infection control measures are followed during courses and disinfection of all equipment at the end of each course or as needed during the course.
• Complete and submit the PCR to the Program Director. Instructors should be trained in the completion of the post course report. Accurate completion of the PCR is the responsibility of the course director/lead instructor.
• Ensure students comply with standards of the MTN and the AHA.
Program Administrator Responsibilities
The Program Administrator is responsible for maintaining records and submitting reports. The Program Administrator is appointed by the TS Program Director using the Program Administrator appointment form (Appendix A and B).
Administer training programs in accordance with AHA and MTN guidelines. Keep abreast of all MTN policies and updates.
Ensure the appropriate records and reports are maintained at the TS and submitted to MTN no later than the suspense dates set by MTN.
Maintain adequate training resources (e.g., space, textbooks, equipment, and supplies).
Participate in Self-Assessment, Administrative, and Course Monitoring Reviews.
Share responsibility for accountability and security for MTN wallet cards and test materials with the Program Director. Issue MTN cards or certificates as applicable. Any excessive mishandling or misuse of MTN wallet cards must be reported to the Commander/Commanding Officer and the MTN. An investigation will be conducted at the TS unit’s expense. Intentional mishandling or misuse of MTN wallet cards constitutes Fraud, Waste and Abuse.
Serve as the primary contact between the TS and the MTN.
Does not need to be an AHA/MTN instructor but must have an understanding of the programs.
Appointment Criteria
The Program Administrator cannot be the same person as the Program Director. The Program Administrator is typically an individual assigned to the TS education and training office. Additional criteria are at the discretion of the Program Director.
Length of Appointment
Program Administrator appointments are TS specific and do not transfer with the individual. Length of the appointment is at the Program Director’s discretion.
Program Administrator Orientation
Each TS will develop a Program Administrator orientation training program that includes, but is not limited to the following.
• MTN Administration Handbook overview/familiarization
• MTN website familiarization
• Local TS standard operating procedures and guidelines
• Equipment familiarization, assembly, disassembly, and decontamination
• Completion of MTN forms, program documentation and records maintenance
• Audit of at least one course per discipline for familiarization
The Program Director will document the orientation on the Program Administrator’s appointment form and submit to MTN.
3-3. Administrative Separation of Duties
The Program Director and Program Administrator may not be the same individual. There is an inherent potential for fraud if the same individual is allowed to both request and distribute MTN/AHA materials. This separation of duties allows for a check and balance system. All MTN affiliated instructors, TSF, Program Administrators, and Program Directors are required to report all instances of suspected unauthorized activity to the respective MTN Program Manager.
3-4. Course Director Orientation
TSF are charged with selecting and training experienced instructors to become course directors/lead instructor. MTN requires that all course directors/lead instructors receive an orientation. Document this training in the instructor’s record.
The purpose of the Course Director Orientation is to prepare instructors selected by the TS to plan, organize, and successfully conduct a Provider or Provider Renewal Course. In addition to helping the instructor conduct a successful course, the goal of orientation is to ensure that the Course Director can accurately instruct, evaluate, monitor, and mentor instructor candidates for their ability to teach and their proficiency in a particular discipline.
The TS will determine the format of the Course Director Orientation. Either the Program Director or a TSF may conduct the orientation. The orientation may take one of the following formats:
• Formal presentation
• Self-paced instruction
• Audiotape or videotape presentation
• Interactive software
• One-on-one mentoring
• Other Alternative Formats
MTN recommends the following content for the orientation:
• Review the MTN Administrative Handbook
• Review of educational principles and course requirements outlined in the Instructor Manual
• Review of course requirements in accordance with the current AHA Guidelines
• Discussion of course format for specific audiences and locations
• Outline of materials and equipment needed to conduct a course
• Discussion of administrative, logistical, and educational problems that can arise during a course and how to manage them effectively
• Discussion of the Course Director’s quality-assurance responsibilities
• Review of methods and skills for monitoring and mentoring instructors
• Review of the TS policies and procedures, including equipment/manikin maintenance and decontamination, quality assurance plan, internal TS dispute resolution policy
Chapter 4: COURSE MATERIALS AND EQUIPMENT
4-1. Course Materials
The AHA approves vendors to distribute AHA materials. Vendor links are available on MTN’s website usuhs.mil/mtn/. Some vendors provide a discount to MTN affiliates; in order to receive this discount it may be necessary to identify yourself as an MTN affiliated TS when ordering.
Training Sites will use the most current editions of AHA textbooks and course materials. The MTN supplies written examinations, answer keys and course completion cards to training sites. Keep all materials in a secure storage area.
Each training site will provide the following items to each course participant:
• A course agenda that includes dates, times, locations, topics and assigned instructors
• Pre-test online access information (if required), post-tests, and blank answer sheets
• Post-tests are distributed in a controlled environment with an instructor present to proctor the exam. Post-tests will not be issued to any individual outside of an established course, this includes instructors
• An MTN approved course evaluation form that allows the participant to provide
feedback. Regardless of the course size, all students will receive the opportunity to
complete a course evaluation
• Skills performance sheets and other handouts as determined by the TS staff
• Personal protective equipment including a one-way valve and/or mouth to mask device
4-2. Non-AHA Material/Information
Adding non-AHA content to the courses is not advisable. There is educational evidence that adding content to the course may actually decrease learning and retention. Although it is not considered a best practice to add to the course, instructors may add related topics as long as none of the required AHA lessons or course content is eliminated or shortened. Any additional topics or information should be added at the beginning or end of the course so that the additional information does not disrupt the flow of the required lessons. Additional information will increase course time.
The instructor must inform students of any additional information that is from non-AHA sources, such material must be clearly labeled as not being AHA-approved.
The use of non-AHA scientific or course material covering the core content or course curriculum is not permitted as a substitute for AHA core curriculum of course materials. The Program Director must approve any supplementary materials before the course.
4-3. Copyright of AHA Materials
The AHA owns the copyrights to AHA textbooks, manuals, and other ECC training materials. These materials may not be copied, in whole or in part, without prior written consent from the AHA. Training Sites must go through the MTN to process these requests. All material found to be in violation of the AHA copyright will be destroyed immediately.
4-4. Training Equipment
The use of manikins and equipment that allow demonstration of core skills of the course (i.e., airway management, jaw thrust, correct hand placement, etc.) is required for all AHA ECC courses. Equipment for each course is listed in the course-specific instructor manual. All equipment used must be in proper working order and good repair.
Manikins and contaminated equipment must be decontaminated according to the manufacturer’s recommendations and CDC guidelines.
The MTN or AHA neither endorses nor recommends any particular brand of manikin or other course equipment. The decision on which brand or model of equipment to use is the responsibility of the TS.
4-5. Quality Assurance
Quality assurance is key to an effective ECC training program. The TS is responsible for the quality of its programs. The components of a quality assurance program include but are not limited to:
• Compliance with MTN/AHA policies and guidelines
• Course agendas include all AHA core content
• Records and files are complete and properly maintained
• A mechanism for developing, monitoring, renewing and updating instructors
• A mechanism to evaluate courses, instructors and program administration
4-6. Controlled Items
Course completion cards and examination materials must be kept secure in a double locked location. The standard for control is met when cards and examinations are secured in a manner that allows only authorized personnel to have access to them; this will include, at minimum, a key or combination locked compartment/container (e.g. box with a lock, locking file cabinet, or a locking drawer). When not being actively used, this compartment/container will be secured. In addition, when the room/building that the compartment/container is located in is vacant, the room/building should be secured.
TS will have a written policy stating how controlled items are secured, who has access and how items are distributed to instructors and satellites.
4-7. Instructor Materials, Equipment and Supplies
Refer to the respective instructor manual for a complete list of necessary equipment and supplies. Training sites and instructors are responsible for all equipment listed in the instructor manual. The ratios given on these lists are not recommendations, they are minimum requirements. In addition, these lists can be found on the MTN webpage at usuhs.mil/mtn .
CHAPTER 5: REPORTS
5-1. Reports
Mandatory reporting for all MTN affiliated training sites is required. Reports will be submitted on time to MTN as stated below. The information presented in the reports are processed and stored for reference purposes. Reports will be maintained at the TS for three years. All correspondence submitted electronically to MTN must be named/identified by the sending unit/site. In the “Subject line”, note your TS/discipline/subject (e. g. Unit Name/BLS/Annual Report).
MTN affiliated training sites are required to use the most current versions of MTN forms. All forms can be found on MTN’s webpage: usuhs.edu/mtn. No other forms are authorized. Reports and packages submitted on obsolete forms will not be accepted for processing and will be returned to the TS for correction.
5-2. Basic Life Support Reports
Post Course Reports
Must be completed within 30 days of a course. The BLS PCR is an internal document maintained at the TS and not mailed to the MTN. However, the TS should be prepared to provide upon MTN’s request.
The BLS PCR is required to have the following forms. All required documentation must be entered. Refer to Appendix A and B for examples.
• BLS Post Course Report Cover Page (for TS reference only)
• Grade Report. Complete using only the approved key found on the form.
• Course agenda. The agenda includes the course content areas with date, time and location, along with the specific instructor teaching assignments.
• Course evaluation summary. The MTN Course Evaluation Form is mandatory and reflects AHA required content. Each student is encouraged to provide feedback by completing the evaluation form. Feedback obtained from the evaluations is used to improve future courses. The TS will prepare a summary of all student evaluations received for a particular course and attach to the PCR. Next to the answers on the form, tally the total number student responses for that answer. The TS need only keep individual evaluations if there was a problem with the course.
• Instructor Renewal Form(s) (as applicable).
• For instructor level courses, attach copies of the Instructor Candidate Applications.
BLS Annual and Semi-annual Reports
The BLS Annual Report/Affiliation Package is due to the MTN no later than September 30 of each fiscal year. Complete all pages of the BLS Semi-Annual/Annual Report form. Refer to Appendix A and B for forms and examples.
The BLS Semi-Annual Report is due to the MTN no later than March 31 of each fiscal year. Complete only page one of the BLS Semi-Annual/Annual Report form and include appropriate signature blocks and signatures. Refer to Appendix A and B for forms and examples.
Ensure the semi-annual and annual report forms have updated and accurate contact information (address, telephone, and email) for TS staff. P.O Box addresses are not accepted as a valid mailing address unless a building number is provided and a mailroom representative is present to sign for incoming correspondence. Abbreviated command names must be accompanied by full name. Program Director and Program Administrator must use the command address where the program is affiliated and not where they are stationed. Naval vessels will annotate home port.
Card accountability and accurate card counts are critical to successful program management. The Program Director/Program Administrator must have a method (ledger, tracker, etc.) to track card receipt and distribution. Contact MTN for assistance.
5-3. ACLS, PALS Reports
Post-Course Reports
PCRs are due to the MTN no later than 30 days following a course. The PCR contains the following six forms (Appendix A and B). All required documentation must be completed.
• Post Course Report Cover Sheet (for TS reference only)
• Grade Report (Instructor or Provider Course specific). Include complete student information and their licensure/certification. Complete the Grade Report using only the approved key found on the form. Training sites approved for CE through their service CE provider may use the CME column as appropriate.
• Course agenda. Use the agenda that was pre-approved by the MTN during program affiliation/re-affiliation and add the specific instructor teaching assignments. If deviations from approved agendas are desired, they must be pre-approved by the MTN Program Manager
• Course evaluation summary. The MTN course evaluation form is mandatory and reflects AHA required content. Each student is encouraged to provide feedback by completing the critique form. The TS will prepare a summary of all student evaluations received for a particular course and attach to the PCR. Next to the answer on the form, tally the total number student responses. The TS need only keep individual evaluations if there was a problem with the course.
• Instructor Renewal Form(s) (as applicable).
• For Instructor level courses, attach copies of the Instructor Candidate Applications.
The Annual Report/Re-affiliation Request is due to the MTN no later than September 30 of each fiscal year. The forms can be used for either the PALS or ACLS program. Submit PALS and ACLS annual reports on separate forms with aggregate data from the previous 12-month period (October 1 – September 30). Refer to Appendix A and B for forms and examples. The package contains the Annual Report forms and re-affiliation forms to request approval to teach in the upcoming fiscal year.
Card accountability and accurate card counts are critical to successful program management. The Program Director/Program Administrator must have a method (ledger, tracker, etc.) to track card receipt and distribution. Contact MTN for assistance.
5-4. Annual or Semi-Annual Report Delinquency
If a complete and accurate report is not submitted by the suspense date, the report is considered late. If an Annual or Semi-Annual report is not received by the suspense date, the MTN Program Manager initiates the following actions.
• < 15 Days: The MTN Program Manager contacts the Program Administrator and/or Program Director. The TS is in jeopardy of being placed on hold.
• 15-20 Days: The senior leadership of the TS is contacted to inform them of the report delinquency and to advise TS to suspend teaching.
• 30 Days: The TS is placed in suspension. The MTN Director notifies the Commander/Commander Officer and appropriate NF of the action. Cancellation of suspension is handled on a case-by-case basis. Typically the TS will complete a new affiliation request.
• 30-45 Days: If the report is delinquent past 45 days, the training site is disaffiliated. The MTN Director notifies the Commander/Commanding Officer and appropriate NF of the action. Exceptions to this policy will be handled on a case-by-case basis with prior coordination with MTN.
If the TS is disaffiliated or does not re-affiliate, it is responsible for the following:
• Ensure records are updated and any pending cards are issued
• Return all unused wallet cards and examination materials to MTN
• Submit an Annual Report for the current fiscal year
• Maintain course records for three years
5-5. Re-affiliation
Training sites re-affiliate annually by submitting an affiliation/ re-affiliation request package along with their annual report. The affiliation/ re-affiliation request package contains the following documents:
• Affiliation/ re-affiliation request form: ensure form has updated and accurate contact information (address, telephone, and email) for the training site staff.
• Projected course listing (ACLS, PALS and PEARS only)
• Instructor List
• Submit agendas if there is a change from the agendas posted on the MTN website
After the annual report and faculty appointments are verified, the Program Manager will send an affiliation memorandum and a projected supply of wallet cards. Completed affiliation packages take approximately four to six weeks for processing. Additional time may be needed for corrections.
CHAPTER 6: RESUSCITATIVE MEDICINE COURSES
6-1. MTN Provider Courses
|BASIC LEVEL COURSES |
|Course |Modules |Description |Intended Audience |
|Heartsaver CPR AED |Adult CPR AED (with a mask)|The Heartsaver CPR AED Course teaches CPR, AED use, |Anyone with limited or no medical training. For those|
| |Adult Choking |relief of choking in adults and children, and infant CPR |who have a duty to respond to a cardiac emergency |
| | |and relief of choking and use of barrier devices of all |because of job responsibilities or regulatory |
| | |ages. |requirements. |
| |Optional modules: | | |
| |Child CPR AED | | |
| |Child Choking | | |
| |Infant CPR | | |
| |Infant choking | | |
|BLS for Healthcare Provider |Basic Life Support for |The BLS for Healthcare Providers Course covers core |For healthcare providers such as EMS personnel, |
| |Health Care Providers |material such as adult and pediatric CPR (including |physician assistants, doctors, dentist, nurses, and |
| | |two-rescuer scenarios and use of the bag mask), foreign |respiratory therapists who must have a credential |
| | |body airway obstruction, and automated external |(card) documenting successful completion of a CPR |
| | |defibrillation. |Course. |
|ADVANCED LEVEL COURSES |
|Course |Modules |Description |Intended Audience |
|Advanced Cardiac Life Support|Advanced Cardiac Life |Through the ACLS course, healthcare providers will |For emergency, intensive care, or critical healthcare |
|(ACLS) |Support |enhance their skills in the treatment of the adult victim|providers such as physicians, nurses, emergency |
| | |of a cardiac arrest or other cardiopulmonary emergencies.|medical technicians, paramedics, respiratory |
| | |ACLS emphasizes the importance of basic life support CPR |therapists, and other professionals who may need to |
| | |to patient survival; and the importance of effective team|respond to cardiovascular emergency. |
| | |interaction and communication during resuscitation. | |
|Pediatric Advanced Life |Pediatric Advanced Life |The goal of the PALS course is to aid the pediatric |or pediatricians, emergency physicians, family |
|Support (PALS) |Support |healthcare provider in developing the knowledge and |physicians, physician assistants, nurses |
| | |skills necessary to pediatric healthcare provider in | |
| | |developing the knowledge and skills necessary to | |
| | |efficiently manage critically ill infants and children, | |
| | |resulting in improved outcomes. Skills taught include | |
| | |recognition and treatment of infants children at risk for| |
| | |cardiopulmonary arrest; the systemic approach to | |
| | |pediatric assessment, effective respiratory management; | |
| | |defibrillation and synchronized cardioversion; | |
| | |intraosseous access and fluid bolus administration; and | |
| | |effective resuscitation team dynamics. | |
| |Pediatric Emergency |The PEARS Provider Course is designed to help the basic |The AHA developed the PEARS Provider Course for |
| |Assessment, Recognition and|pediatric healthcare provider develop the knowledge and |healthcare providers who might encounter pediatric |
| |Stabilization (PEARS) |skills for emergency assessment and treatment of |patients in their profession but who do not routinely |
| | |seriously ill infants and children. |provide care for children with high-acuity illness or |
| | | |injury. This course is not intended for those |
| | |In this course students will learn how to |Who require credentialing in advanced pediatric skills|
| | |Recognize respiratory distress and failure, shock and | |
| | |cardiac arrest |Who are routinely involved in resuscitation. |
| | |Provide appropriate lifesaving actions within the initial|Pears Providers may include |
| | |minutes of response until the child is transferred to an |Medical and surgical nurses |
| | |advanced life support provider |EMT-B and EMT-I |
| | | |Healthcare providers who care for children outside the|
| | | |critical care areas |
6-2. MTN Instructor Courses
Basic Cardiac Life Support.
Course Goal and Objectives
The AHA designed the BLS Instructor Course and Heartsaver Instructor Course to prepare people to become BLS or Heartsaver instructors. At the end of the BLS Instructor Course or Heartsaver Instructor Course, instructor candidates will be able to teach a BLS or Heartsaver course, as appropriate to instructor discipline, using the videos and lesson maps that are part of the appropriate BLS or Heartsaver course instructor materials. Instructor candidates will also be able to use the testing materials to conduct skills testing.
Audience and Prerequisites
Anyone who wants to become an AHA BLS or Heartsaver instructor can take this course. The ideal candidate will be motivated to teach, facilitate learning, and ensure that students acquire the skills necessary for successful course completion, and view student assessment as a way to improve individual knowledge and skills.
Prospective instructors must:
• Have completed the discipline-specific AHA Instructor Essentials Course
• Be affiliated with an AHA/MTN TS
• Have a current BLS Healthcare Provider Card for the BLS Instructor Course and those attending the Heartsaver Instructor Course must have a current status in courses that provide adult/child CPR (to include AED, mask use, choking), infant CPR (to include mask use and choking) and first aid
Course Completion Requirements
Successful completion of each instructor course consists of instructor candidates facilitating a session where they:
• Attend the entire course
• Instruct a group on practice while you watch the video
• Successfully evaluate another instructor candidate while correctly using the skills testing checklist
• Successfully remediate another student
• Be monitored by a TSF as a new instructor (An instructor card will not be issued until all requirements have been met)
Teaching Requirements
Any current AHA/MTN BLS TSF may teach the BLS or Heartsaver Instructor Course. All instructor course faculty members must be current AHA/MTN instructors in the discipline being taught.
Class Size
The size of each BLS Instructor Course or Heartsaver Instructor Course is flexible based on the number of faculty and equipment. Reference the current Faculty Guides for minimum number of candidates in a class.
Equipment
Refer to the current Faculty Guides for BLS and Heartsaver Instructor Courses.
Advanced Cardiac Life Support
Course Goal and Objectives
The AHA designed the ACLS Instructor Course to prepare individuals to become instructors in advanced cardiovascular life support. By the end of the ACLS Instructor Course, instructor candidates will be able to teach an ACLS course using the video and lesson maps in the ACLS course instructor materials. Candidates will also be able to use the new testing materials to conduct skills testing.
Audience and Prerequisites
Anyone who wants to become an AHA ACLS instructor can take this course. The ideal candidate will be motivated to teach, facilitate learning, ensure that students acquire the skills necessary for successful course completion and view student assessment as a way to improve individual knowledge and skills.
Prospective instructors must
• Have completed the discipline-specific AHA Instructor Essentials Course
• Be affiliated with an AHA/MTN Training Site
• Have a current AHA ACLS Provider Status
• Have a current AHA BLS-HCP certification
Course Completion Requirements
For successful completion of the ACLS Instructor Course, the instructor candidate must:
• Attend the entire course
• Instruct a group on the team concept
• Successfully evaluate another student running a mega-code while correctly using the skills testing checklist
• Successfully remediate another student
• Be monitored by a TSF as a new instructor (An instructor card will not be issued until all requirements have been met)
Teaching Requirements
Any current AHA/MTN ACLS TSF may teach the ACLS instructor course. All instructor course faculty members must be current AHA/MTN instructors in the discipline being taught.
Class Size
The size of each ACLS Instructor Course is flexible based on the number of faculty and equipment. Reference the current Faculty Guide for minimum number of candidates in a class.
Equipment
Refer to the current ACLS Instructor Course Faculty Guide.
PALS Instructor Course
Course Goal and Objectives
The AHA designed the PALS Instructor Course to prepare individuals to become instructors in pediatric advanced life support. By the end of the PALS Instructor Course, instructor candidates will be able to teach a PALS course using the video and lesson maps in the PALS course instructor materials. Candidates will also be able to use the new testing materials to conduct skills testing.
Audience and Prerequisites
Anyone who wants to become an AHA PALS instructor can take this course. The ideal candidate will be motivated to teach, ensure that students acquire the skills necessary for successful course completion, facilitate learning, and view student assessment as a way to improve individual knowledge and skills.
Prospective instructors must:
• Have completed the discipline-specific AHA Instructor Essentials Course
• Be affiliated with an AHA/MTN Training Site
• Have a current AHA PALS Provider Status
• Have a current AHA BLS-HCP certification
Course Completion Requirements
For successful completion of the ACLS Instructor Course, the instructor candidate must:
• Attend the entire course
• Instruct a group on the team concept
• Successfully evaluate another instructor candidate’s core case test while correctly using the case test checklist
• Successfully remediate another student
• Be monitored by a TSF as a new instructor (An instructor card will not be issued until all requirements have been met)
Teaching Requirements
Any current AHA/MTN PALS TSF may teach the PALS instructor course. All instructor course faculty members must be current AHA/MTN instructors in the discipline being taught.
Class Size
The size of each PALS Instructor Course is flexible based on the number of faculty and equipment. Reference the current Faculty Guide for minimum number of candidates in a class.
Equipment
Refer to the current PALS Instructor Course Faculty Guide.
Chapter 7: Training Site Reviews
7-1. Training Site Reviews
Introduction
The MTN and AHA goal is to provide quality programs that ultimately improve the outcomes for victims of cardiac and respiratory emergencies. The MTN TS review program promotes quality assurance and process improvement.
Objectives of the review program are to:
• Provide TSs with the tools needed to improve their training programs
• Ensure compliance with MTN/AHA program guidelines
• Provide feedback using an objective method of scoring
• Foster mentoring versus disciplinary actions
Types of Reviews
Self-Assessment
Reviews that are completed by the training site staff and a Commander/Commanding Officer appointed auditor.
Administrative Reviews
Reviews that are conducted by the MTN staff or their designees during periodic site visits.
Course Monitoring Reviews
Reviews that are conducted by the MTN staff on training sites during periodic site visits.
7-2. Training Site Responsibilities
Each TS is responsible for the following:
• Maintain an administrative binder as mentioned in Chapter 2.
• Complete and submit a Self-Assessment review every two years. The Commander/Commanding Officer assigns an impartial officer or senior enlisted (E7 or above) to perform the Self-Assessment Review.
• The TS staff participates in Administrative and Course Monitoring reviews conducted by MTN staff. The appointed Program Administrator(s) must be present during the review. Failure of Program Administrators to be present for reviews will result in the suspension of the TS’s affiliation until such time as a revisit can be completed. All return visits will be at the expense of the TS. TSF and Program Directors are encouraged to participate.
7.3. Scheduling Training Site Reviews
Scheduling of administrative and course monitoring reviews is coordinated between the MTN and the TS. The MTN will contact the TS in advance of a proposed review. The MTN reserves the right to conduct unannounced SAVs. Administrative reviews may be requested by the TS, such requests will be considered on a case by case basis.
Course monitoring reviews occur in conjunction with one or more training courses at the TS.
Once scheduled, the MTN Director has the authority to confirm, delay or postpone a SAV. Such actions are coordinated with the TS’s Program Administrator and Program Director.
7-4. Self-Assessment Reviews
The self-assessment review utilizes focused areas in the administrative review checklist and consists of four sections: Organization-Focused Functions, Course-Focused Functions, Instructor-Focused Functions, and Equipment-Focused Functions (Appendix D).
The purpose of the review is to determine how the TS:
• Allocates resources
• Utilizes AHA materials
• Maintains security
• Develops and maintains course and instructor files
The checklist can be used for any of the three ECC programs. Instructions are included with the checklist.
The reviewer will brief the TS command prior to forwarding the completed checklist to the MTN.
The MTN will only provide the TS with an after action report in the event remediation is necessary. The after action report will include feedback and guidance regarding compliance.
7-5. Administrative Review
The Administrative Review consists of four sections: Organization-Focused Functions, Course-Focused Functions, Instructor-Focused Functions and Equipment-Focused Functions (Appendix D).
The purpose of the review is to determine how the TS:
• Allocates resources
• Measures, analyzes, and improves their organization’s processes
• Utilizes MTN/AHA materials and maintains security
• Develops and maintains course and instructor files
The review takes place at the TS and primarily involves the MTN reviewer or review team and Program Administrator. The Program Director and TSFs are encouraged to participate.
The reviewer(s) ensure that all pertinent standards have been addressed, make overall observations about compliance, and provide consultation and education.
The MTN provides the TS with an after action report that includes feedback and guidance regarding compliance and remediation if necessary.
The MTN aggregates data from multiple training sites to determine trends and guide overall program improvement.
7-6. Course Monitoring Review
The Course Monitoring Review consists of three sections: Facility/Class Structure, Course Content, and Equipment/Materials (Appendix D).
The purpose of the review is to determine how the TS:
• Allocates resources to accommodate class size
• Incorporates course content
• Utilizes required equipment and AHA materials
The review takes place at the TS and primarily involves the MTN reviewer or review team and Program Director. Program Administrator, TSFs, and Instructors are encouraged to participate.
The reviewer(s) ensure that all pertinent curricular standards have been addressed, make overall observations about compliance, and provide consultation and education.
The MTN provides the TS with an after action report that includes feedback and guidance regarding compliance and remediation if necessary.
The MTN aggregates data from multiple training sites to determine trends and guide overall program improvement.
7-7. Scoring and Remediation
TS Reviews are designed to be educational and consultative in nature. After a checklist is scored, a percentage of compliance is calculated that equates to a numerical rating (Administrative and Self-Assessment Reviews) or rating scale (Course Monitoring Reviews). The MTN may, at any time, revise the attached checklists or rating scheme based on current AHA guidelines.
Ratings are as follows:
Administrative and Self-Assessment Reviews
• Rating 1 = 95-100% Assessment provides evidence of excellent compliance.
• Rating 2 = 80-94% Assessment provides evidence of acceptable compliance.
• Rating 3 = 70-79% Assessment does not provide evidence of acceptable compliance. Additional documentation within 30 days.
• Rating 4 = < 70% Assessment does not provide evidence of acceptable compliance. Additional documentation within 30 days and a focused admitting review within 90 days at TS expense.
• A score of 70 – 79 % (rating of 3) or less than 70% (Rating of 4) in any individual section that cannot be resolved during the review visit triggers additional action and follow-up. A plan to correct the deficiency is developed on a case-by-case basis.
Course Monitoring Review
• Successful monitoring with Recommendations (All “Yes” Scores)
• Successful monitoring with Required Improvements (Scored Mostly “Yes” with some “Yes, with Requirements”; no more than one “No” score)
• Unsuccessful monitoring, Required Improvements Noted (2 or more “No” scores)
A follow-up visit may be indicated at the discretion of the MTN or at the request of the TS Commander/Commanding Officer. All follow-up visits will be at expense of the TS.
If the TS is unable to achieve compliance after remediation, the MTN Director may temporarily or permanently suspend the affiliation of the TS.
Chapter 8: Advanced Trauma Life Support (ATLS)
8-1. Introduction
This section describes administration of the ACS ATLS training program. The ACS ATLS program and materials are protected under applicable international copyright law. The ACS ATLS for Doctors; Instructor Course Manual is a required reference.
8-2. Administration of MTN ATLS Programs
The ACS has divided the ATLS program into 17 regions. Regions 1-10 are located in the United States. Regions 11 and 12 are located in Canada. Region 13 is the MTN including its training sites worldwide. The last four regions are “Other/International” and “Latin and South America."
Training sites have two appointed staff and a cadre of instructors that provide ATLS courses. The TS receives administrative oversight from the ATLS Program Manager and the MTN Director. The COT Chairperson(s) provides expert curricular oversight and guidance to the TS staff. Each branch of the service has one COT Chairperson who is responsible for all ATLS activities taking place in that service. The Region 13 Chief serves as the senior consultant between the three COT chairpersons and the ACS. The ATLS Program Manager provides administrative coordination between the TS, Instructors, COT chairpersons, Region 13 Chief, and the ACS. A diagram of the organizational structure follows:
[pic]
8-3. MTN ATLS Program Manager
ATLS Program Manager
Military Training Network
USUHS Southern Region
2787 Scott Road
JBSA Fort Sam Houston Texas, 78234-7679
E-mail: mtnreports@usuhs.edu
8-4. Training Site Responsibilities
Sites must maintain or have access to the following:
• An adequate number of ACS recognized ATLS instructors
• Training equipment and supplies as described in the ATLS for doctors, Instructor Course Manual
• Have access to sufficient classroom and laboratory (skill station) space
• Courses must be held at TSs approved by the service COT Chairperson, with concurrence of the Region 13 Chief
Educational objectives must be met according to the guidelines in the ATLS Instructor Course Manual. All core course content must be included.
Course focus is on interactive learning with hands-on skills practice. All students are given an opportunity to practice skills under the supervision of an instructor who provides feedback.
Courses must adhere to the student-to-instructor and student-to-manikin ratios outlined in the ATLS Instructor's Manual.
Participants must attend all course sessions (lectures and stations) as established by the ATLS Course Director in order to receive a completion card.
Only medical doctors are authorized by the ACS to receive a provider card.
8-5. ACS Course Materials
The ATLS manuals and related course slides are copyrighted by the ACS and may not be reproduced without permission from the ACS. Forms found in the ATLS Instructor Manual may be duplicated for direct use in an ATLS course. Course materials are not available on an open sale basis and may only be purchased from the ACS in conjunction with each authorized ATLS course. Prepayment for course materials is required.
Current ATLS instructors may procure replacement or new editions of ATLS Instructor Manuals. The instructor submits a request to the COT Chairperson for endorsement. Once approved the request is sent to the ACS for processing. Direct procurement of the ATLS Instructor Manual is otherwise not authorized.
8-6. Written Examinations
Written examinations will not be altered in any way. Any concerns regarding specific questions or answers may be referred to the ATLS Course Director.
To evaluate the student’s understanding of the course material, the examination is completed by each student individually. Testing must occur in a monitored setting.
Provider course students must score 80% or higher to “Pass” the examination. Students who score below 80% receive remediation and are re-evaluated with a second version of the written examination in accordance with the ACS Guidelines.
8-7. Training Equipment
The equipment required for an ATLS course is listed in the ATLS Instructor Course Manual. All items except those identified as optional must be available for faculty demonstration and student practice. Equipment should be of the same make and manufacture as the actual equipment that the facility/students use in the clinical setting. The surgical skills practicum is conducted: in an animal research facility or cadaver laboratory, or using an ACS approved ATLS manikin.
8-8. Training Site Staff
Course Director
Position Description: The Course Director is responsible for all aspects of an ATLS course at the TS. Course Directors are surgeons and typically the senior or most experienced TS ATLS Instructor. The Course Director is nominated by the COT Chairperson and appointed by the ACS.
Course Director Responsibilities
• Implement and manage ATLS courses in accordance with ACS guidelines
• Notify the MTN of problems, disputes, or other concerns
• Ensure the appropriate records and reports are maintained at the TS and forwarded to MTN by the suspense dates
• Secure adequate training resources (e.g. space, textbooks, and equipment)
• Share responsibility and accountability for ACS course materials
Appointment Criteria
• A surgeon and current ATLS instructor.
• Must be monitored in the Course Director role by an ACS State Faculty or higher during an ATLS course. Monitoring is documented on a Course Director critique form and included with the PCR.
Course Coordinator
Position Description: The Course Coordinator is responsible for all administrative aspects of conducting an ATLS course.
Course Coordinator Responsibilities
• Administer ATLS training courses in accordance with ACS guidelines
• Ensure the appropriate records and reports are maintained at the TS and forwarded to MTN via the ACS Online Submittal by the suspense dates
• Obtain and maintain adequate training resources (e.g. space, textbooks, equipment, and supplies)
• Share responsibility and accountability for ACS course materials.
Appointment Criteria
• Cannot be the same person as the Course Director
• Typically an individual assigned to the education, training, or surgical departments
• Must audit a student course and be monitored in the Course Coordinator role by an experienced Course Coordinator during a subsequent ATLS course.
The Course Coordinator critique forms are completed along with the PCR. The COT Chairperson endorses the recommendation and the ACS promotes the individual to the Course Coordinator position.
ATLS Educator
Position Description: Qualified Educators effectively demonstrate a variety of teaching skills to students in the ATLS Instructor Course.
Responsibilities
• Implements the guidelines found in the Teaching the ATLS Instructor Course: A Curriculum for Educators, section of the ATLS Instructor Manual
• Presents all teaching-how-to-teach lectures at the instructor course
• Provides feedback and critiques to students and faculty
Appointment Criteria
An ATLS Educator should have a master’s or doctorate degree with concentration or specialization in education as well as experience in postsecondary teaching. A qualified applicant is recommended by the COT Chairperson, attend or audit an ATLS student course, and receive educator training and monitoring from a National Educator during an Instructor course.
Length of appointment
Upon successful completion of the nomination, training, and monitoring phases, Educators are added to the ACS list of approved Educators. Educators are required to verify their status every four years.
8-9. Instructor Records
The ACS maintains instructor records including teaching histories. The Course Director is responsible for verifying the instructor status of faculty prior to each course. Each TS will make the determination on the need to maintain individual instructor folders at their level.
8-10. Student and Instructor Post Course Reports
The Course Coordinator is responsible completing the PCR forms and sending the necessary documents to the ATLS Program Manager within 30 days of course completion. All PCRs must be submitted via the ACS Online ATLS Report Submission Webpage. All exceptions to this practice must be approved by the ACS.
8-11. Maintenance of Course Records
The ACS maintains all necessary records of ATLS courses.
8-12. Advanced Trauma Life Support Course Procedures
Requesting a Course
The TS Course Coordinator completes the online Course Request Authorization Form (CRA) at least eight weeks prior to the requested course date. Final course approval comes once the ACS Region 13 Coordinator who will issue a course serial number.
After the TS Course Coordinator receives the course serial number he/she may purchase ATLS Student Course Manuals and other teaching materials. Students should receive the ATLS Student Course Manual 30 days prior to course. Please note: if the TS has a delinquent PCR or outstanding balance due, the ACS will not approve the CRA.
Post Course Reports
The Course Coordinator and Course Director are responsible for submitting the PCR within 30 days of completing a course. All forms not completed online will be sent to the MTN ATLS Program Manager for review and then forwarded to the COT Chairperson for approval.
The TS maintains the student initial assessment forms, skill station work sheets, final evaluation forms and test answer sheets. Do not include these items with the PCR unless the Course Coordinator and/or Course Director have concerns about a particular student’s performance. Scan and submit the ATLS PCR electronically to the MTN ATLS Program Manager, COT and ACS simultaneously. The PCR should contain: an overall summary cover letter, class schedule, student rotation schedule, ATLS disclosure handout list, any financial disclosures not submitted online, and any candidate application critiques.
ATLS cards are generated and provided by the Course Director at the end of each course. The ATLS Program Manager maintains a copy of the submitted PCR paperwork.
8-13. Advanced Trauma Life Support Courses
Student Course
The Student Course is a two or two and a half day continuing medical education program for doctors. The basic design of the course is described in the ATLS Instructor Course Manual and may not be altered to fit individual or institutional desires. The course provides participants with a safe, reliable method for immediate management of the injured patient and the basic knowledge to:
• Assess a patient’s condition rapidly and accurately
• Resuscitate and stabilize the patient according to priority
• Determine if the patient’s needs exceed the facility’s capabilities
• Arrange appropriately for the patient’s inter-hospital transfer
• Assure the optimum care is provided
Intended Audience
ATLS courses are conducted for doctors. Only doctors, with the following exceptions, may participate in the program and receive documentation of their successful completion from the ACS.
ATLS training may be provided to medical students in their final year of training.
Doctors of Dental Surgery (DDS) and Doctors of Medical Dentistry (DMD) who are actively involved in trauma patient management may participate.
Physician Extenders (PEs), defined as physician assistants and nurse practitioners may participate without expecting or receiving verification of successful course completion. Enrollment of PEs must be pre-approved by the COT chairperson. The level of participation by the PEs is at the discretion of the Course Director with the approval of the COT chairperson. The number of PEs is limited to 25% of the total participants. The PEs may receive a letter from the Course Director that verifies their participation in the course.
Auditors: Individuals may audit the course provided they obtain permission from the COT chairperson on the CRA. Auditors attend the lectures and observe the practical skills stations.
Student Materials
• The ATLS Student Course Manual
• Triage Scenario Workbook
Faculty Materials
• ATLS Instructor Course Manual
• ATLS Slide Set and X-Ray Slide Set
Course materials are not available for open sale. Materials must be purchased from the ACS for an approved ATLS course. Course materials are paid for in advance.
Faculty
• The Course Director must be a fully trained surgeon with ACS qualified National, Regional, State/Provincial, or instructor status
• Additional faculty may include ACS qualified National, Regional, State/Provincial faculty, and ATLS instructors / instructor candidates
• At least 50% of the faculty must have surgical specialties
• An ACS qualified Course Coordinator is required for all ATLS courses
• Only surgeons may present the surgical skills lab
• All faculty must be updated with most current teaching guidelines and materials
Format
Courses are designed for 16 doctors. A maximum of 24 is allowed as long as the student to faculty ratio does not exceed 4:1. If a second Course Director is added to the course, the participant number can go up to 32.
The course schedule will not be altered from the schedule presented in the ATLS Instructor Course Manual. Lectures and skills stations are presented in a prescribed order.
Course Completion
Successful completion of the course is based on the student’s overall performance.
Students who do not attend the entire course must complete all missed portions within 90 days of the original course date.
Students who do not successfully complete the Initial Assessment testing station may be retested at the end of the course or in another course within 90 days of the original course date.
Neither the ACS, MTN, nor COT Chairperson “certifies” participants in continuing education courses. Once the above requirements are met students receive documentation (verification letters or wallet cards) of satisfactory course completion from the ACS. The ATLS wallet card expires four years from the last day of the course.
Students who attend the entire course, regardless of their outcome, are eligible to CME credit hours. The Course Coordinator issues CME cards to the students.
Re-verification at the Student Course Level
To maintain current ATLS status doctors must successful complete a Student Refresher Course or entire Student Course every four years.
The Student Refresher Course is a half-day or one day course that is taught separately or in conjunction with a full Student Course. Individuals who successfully completed a Student Course within four years are eligible to attend. The policies and procedures described for the Student Course (above) are similar to those of the Student Refresher Course. See the ATLS Instructor Course Manual for more information.
Instructor Course
The Instructor Course is a one and a half day course designed to teach doctors to teach in the ATLS program. The basic design of the course is described in the ATLS Instructor Course Manual and may not be altered to fit individual or institutional desires. The course is divided in seven sessions:
• Roles and responsibilities of the instructor
• Course design and learning principles
• Lecturing techniques and mini-lecture practice sessions
• Group discussion techniques and practice sessions
• Skills teaching techniques and practice sessions
• Initial assessment skills teaching techniques and practice sessions
• Closure
Eligibility
ATLS Instructor Course applicants must have successfully completed a Student Course within the two years in which they were identified as instructor potential.
The ACS, ATLS Division gathers all information on potential new instructors from PCRs. The ACS verifies whether an applicant is identified as instructor potential.
If more than two years, but less than four years, has lapsed since the applicant participated in a Student Course, the applicant must successfully complete a Student or Student Refresher Course.
Auditing an ATLS Instructor Course is not permitted.
Student Materials
• The ATLS Instructor Course Manual
• Triage Scenario Workbook
Faculty Materials
• ATLS Instructor Course Manual
• Course materials are not available for open sale. Materials must be purchased from the ACS for an approved ATLS course. Prepayment of all course materials is required.
Faculty
• The Course Director should be the COT Chairperson
• The State COT Chairperson can elevate a state faculty to Instructor Course Director after observing him/her in this capacity
• Additional faculty may include ACS qualified National, Regional, State/Provincial faculty, an Educator, and ATLS instructors
• A qualified ATLS Educator is required for all instructor courses
• An ACS qualified Course Coordinator is required for all ATLS courses
• All instructors must be updated with the most current teaching guidelines and materials
Format
• Courses are designed for nine students. The student to Course Director and Educator ratio must not exceed 9:1 during the presentations and mini-lecture sections. A 3:1 instructor to student ratio is required during the skills stations. If an additional Course Director and Educator are added to the course, the participant number can go up to 18.
• The course schedule should not be altered from the schedule presented in the ATLS Instructor Course Manual. Lectures and skills-teaching stations are presented in a prescribed order.
• The Course Director is responsible for presenting the “Introduction to the Instructor Course” and “Roles and Responsibilities of the Instructor.” A qualified Educator presents all teaching-how-to-teach lectures. Qualified, experienced instructors and a qualified educator conduct all teaching stations.
Course Completion
Successful completion of the course is based on the student’s overall performance. The student must attend the entire course and complete the following:
• Fulfill the course pre-requisites
• Be proficient in the cognitive and practical educational concepts presented in the ATLS teaching materials
• Demonstrate the proper attitude and affect desired of ATLS instructors
After successful completion of the Instructor Course, students are considered instructor candidates. Candidates must complete their teaching requirements in a Student Course within one year of the Instructor Course. The candidate must teach both a lecture and a related skill station. Candidate teachings must be observed and critiqued by the COT Chairperson or representative during this initial performance.
After the ACS receives the Instructor Candidate Critique Form, as part of the PCR, an ATLS Instructor card is generated. The card is mailed to the service COT Chairperson for signature and then it is forwarded to the new instructor. It routinely takes six months for an instructor to receive his/her card.
Neither the ACS, MTN, nor COT Chairperson “certifies” participants in continuing education courses. Once the above requirements are met students receive documentation (verification letters or wallet cards) of satisfactory course completion from the ACS. The ATLS Instructor card expires four years from day the candidate completed the teaching requirements.
Students who attend the entire course, regardless of their outcome, are eligible to CME credit hours. The Course Coordinator issues CME cards to the students.
8-14. Instructor Re-verification
To maintain current ATLS instructor status doctors must be re-verified every four years. The instructor may receive an Instructor Status Notification (ISN) form from the ACS. It is not necessary to receive the ISN in order to request re-verification. Instructors desiring to re-verify their status should contact an ATLS TS for testing material.
Re-verification is voluntary. Instructors with expired instructor status may not teach ATLS. The ACS provides an additional six-month grace period, beyond the card expiration date to complete the re-verification process.
• Instructors must teach four courses in four years, approximately one course per year (minimum). The course in which instructors complete their teaching requirements may count as one of the four required teaching episodes for the first re-verification cycle.
• All instructors must teach a lecture and the related skills station in order to receive one teaching credit.
• Instructors must complete an instructor update when the course is revised.
• Instructors must consistently demonstrate support for the program’s philosophies, competency in teaching the ATLS Program, and a positive attitude.
The ACS will update the instructor’s records and generate a new instructor card. The card is
endorsed by the COT Chairperson and mailed to the instructor.
If circumstances prevent the instructor from completing the re-verification process, the instructor is responsible for contacting the COT Chairperson.
8-15. Requesting a New Training Site
To affiliate a new program, contact the Region 13 ACS Chief. Contact information is available on MTN’s website, usuhs.mil/mtn.
APPENDIX A: FORMS
Electronic versions of mtn forms and FOrms packages are available on the mtn website at usuhs.mil/mtn under the respective program.
training sites should use these, AS they are the most current versions.
Appendix B: Example forms
Appendix C: MTN Course Completion Cards
C-1 Course Completion Cards/Wallet Cards
Wallet cards are issued to students who successfully meet all course requirements. Cards are valid through the end of the month in which the course completion card was issued. Cards must be issued within 20 business days of course completion. Within 10 business days of receiving the completed Instructor Monitor Form, the TS for instructor candidates must issue an instructor card. The MTN provides each TS with wallet cards at no cost. The direct purchase of AHA wallet cards from vendors is not authorized. MTN Program Managers use the training sites PCRs, semi-annual report, and annual report to determine card allocations.
C-2 Replacement of Lost/Damaged Cards
The TS may issue a replacement card if the original is lost or destroyed on a case-by-case basis. The Program Director will verify course attendance before issuing a duplicate card. The word “Duplicate” must be printed on the front of the replacement card. Use the same issue/expirations dates as the original card. The TS accounts for the duplicate card by annotating a replacement issue in that respective card’s accountability ledger.
In instances where the individual’s card will expire within four months, a card will not be issued. The Program Director will issue a locally generate certificate. The member will be scheduled to attend a course.
C-3 Card Security
MTN wallet cards are controlled items. The TS must have a plan to maintain card security and accountability. Only the Program Director, Program Administrator and TSF should have access to MTN cards. The Program Director will only issue cards to students who have completed all course requirements. Damaged, voided, and incorrectly typed cards must be destroyed. Account for destroyed and returned cards on the semi-annual and annual reports and annotate in that respective card’s accountability ledger.
C-4 Preparing Cards
Cards should be typed, stamped or computer generated to reduce the risk of the course cards being altered. All wallet cards must be complete and legible. Cards that are altered in any way are not valid. The format and appearance of wallet cards are periodically revised. Older versions of cards may be issued until stock is deleted or as directed by MTN. Samples and instructions for completing the various types of cards follows:
There are four Provider course specific wallet cards:
BLS Healthcare Provider
[pic]
ACLS Provider
[pic]
PALS Provider
[pic]
PEARS Provider
[pic]
Complete the front of the cards as follows:
• Course name is preprinted on card
• Student’s name (and rank if applicable)
• Issue date in month and year format (e.g. Jan 13)
• Recommended renewal date: two years from the issue date (e.g. Jan 15)
Complete the back of the card as follows:
• Name of MTN Affiliate: enter Training Site’s unit or organizational name
• Signature of Course Director or Program Director
• Holder’s signature
Heartsaver CPR AED
[pic]
Complete the front of the HS CPR AED cards as follows
• Student’s name (and rank if applicable)
• Issue date in month and year format (e.g. Jan 13)
• Recommended renewal date: two years from the issue date (e.g. Jan 15)
• Completed modules are those NOT marked out
Complete the back of the card as follows
• Name of MTN Affiliate: enter Training Site’s unit or organizational name
• Printed name and signature of Course Director or Program Director
• Holder’s signature
• There are five Instructor course specific wallet cards
Heartsaver Instructor
[pic]
BLS Instructor
[pic]
ACLS Instructor
[pic]
PALS Instructor
PEARS Instructor
[pic]
Complete the front of the card as follows
• Course name is preprinted on card
• Student’s name (and rank if applicable)
• Issue date in month and year format (e.g. Jan 13)
• Expiration date: two years from the issue date (e.g. Jan 15)
Complete the back of the card as follows
• AHA Region: enter MTN
• Name of the Community Training Center: enter N/A
• Training Site: enter Training Site’s unit or organizational name
• Name of Course Director or Program Director
• Holder signature
Training Lapse Past Recommended Renewal or Expiration Date
Cards are not valid or recognized by the MTN after the recommended renewal date or expiration date. Individuals with invalid/expired cards should be enrolled in a full course to renew their training. Renewal/refresher courses do not satisfy this requirement.
Appendix D: Training Site Review Forms (Administrative review/COURSE MONITORING REVIEW)
Military Training Network - Emergency Cardiac Care Program
Administrative Review
The Administrative Review is divided into four sections
• Section I Organization Focused Functions
• Section II Course Focused Functions
• Section III Instructor Focused Functions
• Section IV Equipment Focused Functions
This assessment focuses primarily on selected leadership and improving the organization’s performance. It allows the reviewers to discuss data obtained and trended and how the organization uses the data for opportunities of improvement.
Purpose
To review:
• How the TS allocates resources
• How the TS measures, analyzes, and improves their organization’s processes
• How the TS utilizes AHA materials and maintain security
• How the TS develops and maintains course and instructor files
Where will the review take place? At the Training Site.
When will the review take place? At the discretion of the MTN.
Who will participate?
Training Site
• Program Administrator for each program (BLS, ACLS, PALS) that is being assessed
• Program Director(s) and TSF are recommended
• Other staff you may designate
MTN
• MTN staff member, NF member or (non-resident) Program Director
• Additional Staff (optional)
What will occur?
The reviewer or review team will:
• Ensure that all pertinent standards have been addressed
• Make overall observations about compliance
• Provide consultation and education, as time permits
What documents need to be available?
MTN Handbook; TS Program Administration Binder with newsletters, correspondence, TS policies/procedures, appointment letters and affiliation memorandums
• Course Information
• Instructor Information
What are some tips for success?
The following tips are intended as helpful suggestions to successfully achieve compliance with the administrative review.
• Make your MTN Handbook available to key instructors and staff prior to the review
• Be familiar with the Instructor Manual for the discipline(s) being reviewed
• Be familiar with your policies and procedures
Scoring
The scoring section includes a question, or questions, to help you focus on the performance expectation in the standard and identifies the levels of compliance expressed in frequency of compliance or quantitative or qualitative terms.
• The scoring reflects the levels of compliance by section
• Each standard is scored independently by “Yes” Answers
• An “NA” response will be scored as a “Yes”
• In an area where more than one component is being reviewed, a “Yes” must be able to be scored for all. If any part scores a no, then the entire component is a “No”, i.e. Training Sites, Instructor Files, Course Files
Reviewers
Use this form to review all three disciplines. This was developed since the standards and components of an administrative review are consistent throughout the disciplines.
Ratings:
Rating 1 = 95-100% Assessment provides evidence of excellent compliance
Rating 2 = 80-94% Assessment provides evidence of acceptable compliance
Rating 3 = 70-79% Assessment does not provide evidence of acceptable compliance
Rating 4 = < 70% Assessment does not provide evidence of acceptable compliance
A score of 70 – 79 % (Rating of 3) or less than 70% (Rating of 4) in any individual section triggers additional action and follow-up.
Military Training Network - Emergency Cardiac Care Program
Course Monitoring Review
The Course Monitoring Review covers three areas:
• Facility/Class Structure
• Course Content
• Equipment/Materials Available
Purpose: To Review:
• How the TS allocates resources
• How the TS incorporates course content
• How the TS utilize required equipment and AHA materials
Where will the review take place: At the TS or location where courses are taught.
When will the review take place: At the discretion of the MTN.
Who will participate?
Training Site:
• Program Administrator for each program (BLS, ACLS, PALS) that is being assessed
• Training Site Faculty and Program Director(s) recommended
• Instructor(s)
• Other staff you may designate
MTN:
• MTN staff member, National Faculty member or (non-resident) Program Director
• Additional Staff (optional)
What will occur: The reviewer or review team will:
• Monitor course to ensure that all pertinent standards have been met
• Make overall observations about compliance
• Provide consultation and education, as time permits
What are some tips for success?
• Be familiar with the Instructor/Provider manual for the discipline being reviewed
• Be familiar with the exams for the discipline being reviewed
• Have your MTN Handbook, newsletters, and correspondence available
Scoring: The scoring section includes a question, or questions, to help you focus on the performance expectation in the standard and identifies the levels of compliance expressed in frequency of compliance or quantitative or qualitative terms.
• The scoring reflects the level of compliance by section
• Each standard is scored independently by “Yes”, “No”, “Yes, with [specific] comments” , or “No, with specific comments” answers
Ratings:
• Successful monitoring with Recommendations (All “Yes” Scores)
• Successful monitoring with Required Improvements (Scored Mostly “Yes” with
some “Yes, with Requirements”; no more than one “No” score)
• Unsuccessful monitoring, Required Improvements Noted (2 or more “No” scores)
-----------------------
Military Surgeons General
Uniformed Services University, Bethesda Maryland
AHA
ACS
Military Training Network
MTN National
Faculty
Committee on Trauma (COT) Chairpersons
MTN Worldwide Training Sites
Fig 1-1: Structure of the MTN in regards to DoD.
[pic]
Fig 1-3: MTN relationship within the ACS ATLS Program.
[pic]
Fig 2-1: MTN Network relationships diagram
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